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Interventional Radiology in the Management of Abdominal Collections After Distal Pancreatectomy: A Retrospective Review
- Source :
- American Journal of Roentgenology. 197:241-246
- Publication Year :
- 2011
- Publisher :
- American Roentgen Ray Society, 2011.
-
Abstract
- The purpose of this study was to assess the technical and clinical success and complications of imaging-guided percutaneous catheter drainage of peripancreatic fluid collections after distal pancreatectomy.Between January 2001 and February 2009, the cases of patients who underwent distal pancreatectomy were selected from a surgical database, and the cases of those who underwent subsequent interventional radiologic percutaneous drainage were identified. Details of percutaneous catheter drainage were recorded, and technical and clinical success was determined. Technical success was defined as successful percutaneous imaging-guided placement of a drainage catheter. Primary clinical success was defined as resolution of peripancreatic fluid collection with percutaneous drainage only. Secondary clinical success was defined as resolution of peripancreatic fluid collection with percutaneous drainage and additional manipulations (i.e., tube repositioning, additional catheter drainage) and no surgical débridement. Multifactor logistic regression analysis was used to identify predictors of drain failure.Between January 2001 and February 2009, 365 patients underwent distal pancreatectomy. Of these, 51 patients (14%; 25 men, 26 women; mean age, 53.4 years; range, 18-81 years) underwent 57 CT-guided percutaneous procedures for drainage of postsurgical peripancreatic fluid collection. The mean interval between surgery and drainage was 23.5 days (median, 17 days; range, 2-120 days), and the mean collection size was 7.3 cm in transverse dimension (median, 6.9 cm; range, 2.3-16 cm). The mean duration of catheter drainage was 39.7 days (median, 24 days; range, 3-220 days). The technical success rate was 100%, primary clinical success rate was 60%, and primary and secondary clinical success rates together were 95%. Three of the 51 patients (6%) needed surgery for definitive management of the collection. One of 51 patients (2%) had a complication of the interventional radiologic procedure. Catheter size and the need for additional catheter manipulation were significantly associated with drainage failure (p0.05).Catheter drainage of peripancreatic fluid collections after distal pancreatectomy is a technically safe and clinically effective procedure. Although extra manipulations may be needed to achieve clinical success, the combined primary and secondary clinical success rates are high.
- Subjects :
- Adult
Male
medicine.medical_specialty
Percutaneous
Adolescent
medicine.medical_treatment
Suction
Radiography, Interventional
Young Adult
Pancreatectomy
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Drainage
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
General surgery
Ascites
Interventional radiology
Retrospective cohort study
General Medicine
Middle Aged
Surgery
Catheter
Treatment Outcome
medicine.anatomical_structure
Abdomen
Female
business
Distal pancreatectomy
Subjects
Details
- ISSN :
- 15463141 and 0361803X
- Volume :
- 197
- Database :
- OpenAIRE
- Journal :
- American Journal of Roentgenology
- Accession number :
- edsair.doi.dedup.....6f4bb021f76f3c9902bffb9ee4a0a35c