Endoscopic drainage of acute necrotizing pancreatitis-associated abdominal fluid

Background: The treatment of acute necrotizing pancreatitis-associated abdominal fluids is a classic challenge of gastroenterologists and surgeons in this high-risk group of patients.

Aim: We analyzed the results of endoscopic drainage of acute necrotizing pancreatitis-associated abdominal fluids.

Patients and results: In 2003, we performed 7 endoscopic drainage, because of abdominal fluid originated from acute necrotizing pancreatitis (male/female ratio: 2/5; mean age: 62.7 years [42–86]; etiology: 2 alcoholic, 5 biliary). In all patients, the tail region of the pancreas was affected by the necrotizing process. In six cases, we applied jejunal feeding before endoscopic drainage. Through endoscopic cysto-gastrostomy, we implanted one 10 F (6 cases) and two 10 F (1 case) plastic drain at an average time of 19.8 days (10–48) following the onset of pancreatitis. Endoscopic drainage resulted in the emptying of abdominal fluid in all patients. In four patients, the drains were removed after an average time of 3.75 months (1–4). As a complication of drainage, we observed occult gastrointestinal bleeding (1 case), spontaneous drain dyslocation (1 case, re-inserted) and recidive panceratitis (1 case).

Conclusion: Endoscopic drainage of acute necrotizing pancreatitis-associated abdominal fluids can be an effective alternative of surgical operation.