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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(02): 081-086
DOI: 10.1055/s-0042-1751035
Original Article

Feasibility and Safety of Bedside Percutaneous Catheter Drainage of Necrotic Pancreatic Fluid Collections in the Intensive Care Unit

Authors

  • Pankaj Gupta 

    1   Departments of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Shreya Sehgal

    1   Departments of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Jyoti Gupta

    1   Departments of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Jayanta Samanta

    2   Departments of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Harshal Mandavdhare

    2   Departments of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Vishal Sharma

    2   Departments of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Usha Dutta

    2   Departments of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Rakesh Kochhar

    2   Departments of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Manavjit Singh Sandhu

    1   Departments of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Purpose Critically ill patients with acute pancreatitis (AP) require intensive care unit (ICU) admission. The management of pancreatic fluid collections (PFCs) in this group is challenging. We aimed to evaluate the feasibility and safety of bedside percutaneous ultrasound (USG)-guided interventions in necrotic PFC in ICU patients.

Methods This retrospective study comprised consecutive patients with AP in the ICU who underwent bedside USG-guided interventions for necrotic PFC. Indications for intervention, technical success, clinical success, and complications were recorded. The site, number, and size of catheters were recorded. Clinical outcomes were assessed.

Results Thirty-three patients (mean age, 38.1 years, 15 females) were included. All patients had nonresolving organ failure and were on mechanical ventilation. The mean pain to percutaneous catheter drainage (PCD interval was 42.2 days (range, 7–167 days). All the procedures were technically successful, and none of the patients required shifting to the interventional radiology suite for computed tomography guidance. PCD was clinically successful in 40% of the patients. There were no major complications. The mean length of hospital stay and ICU stay was 35 days (range, 6–69 days) and 13 days (range, 1–63 days), respectively. Six (17.1%) patients underwent necrosectomy. Sixteen (45.7%) patients died in the hospital.

Conclusion USG-guided bedside PCD can be performed safely with high technical success in the ICU setting.

Keywords

drainage - collections - catheter - acute necrotizing pancreatitis - ultrasound

Ethical Approval

This was a retrospective study performed at a tertiary care referral center, where a large number of patients with AP are managed. The study was approved by the local ethics committee.




Publication History

Article published online:
02 July 2022

© 2022. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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