Percutaneous radiologic drainage of pancreatic abscesses

Eric Vansonnenberg, Gerhard R. Wittich, Kenneth S. Chon, Horacio B. D'Agostino, Giovanna Casola, David Easter, Robert G. Morgan, Eric Walser, William H. Nealon, Brian Goodacre, Bruce E. Stabile

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE. The purpose of our study was to review and report the patient selection, techniques, and results of percutaneous drainage of pancreatic abscesses by retrospective review. MATERIALS AND METHODS. Fifty-nine patients (46 men and 13 women) with a mean age of 44 years old had 80 pancreatic abscesses that were drained percutaneously under radiologic guidance (CT, n = 77; sonography, n = 2; and fluoroscopy, n = 1). Abscesses had a wide spectrum of causes, with alcoholic pancreatitis being most common, trauma second most common, and gall-stones third. Ten patients had undergone surgery for pancreatic necrosis or abscess. Patients with pancreatic pseudocysts, necrosis, or acute fluid collections were excluded from this study. RESULTS. Of the 59 patients 51 (86%) were cured with percutaneous drainage and antibiotic therapy. Of the patients who were not cured with percutaneous drainage, seven required surgery and one underwent repeat percutaneous drainage. In the 59 patients, complications included non-life-threatening bleeding in three patients. Ten of 59 patients (17%) had fistulas that spontaneously formed into the gastrointestinal tract. The duration of catheterization ranged from 4 to 119 days, with a mean duration of 33 days. The rate of mortality at 30 days after completion of percutaneous drainage was 8% (5 of 59). CONCLUSION. Percutaneous drainage was an effective therapy for this defined group of patients with pancreatic abscesses. Factors leading to the relatively high success rate described in this study likely included selection of patients; catheters of adequate size, number, and location; careful follow-up with appropriate catheter manipulations; and an integrated, cooperative approach whereby surgeons were willing to permit drainage to effect its benefits rather than operating prematurely.

Original languageEnglish (US)
Pages (from-to)979-984
Number of pages6
JournalAmerican Journal of Roentgenology
Volume168
Issue number4
StatePublished - 1997

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Abscess
Drainage
Patient Selection
Necrosis
Catheters
Alcoholic Pancreatitis
Pancreatic Pseudocyst
Fluoroscopy
Gallstones
Group Psychotherapy
Catheterization
Fistula
Gastrointestinal Tract
Ultrasonography
Hemorrhage
Anti-Bacterial Agents
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Vansonnenberg, E., Wittich, G. R., Chon, K. S., D'Agostino, H. B., Casola, G., Easter, D., ... Stabile, B. E. (1997). Percutaneous radiologic drainage of pancreatic abscesses. American Journal of Roentgenology, 168(4), 979-984.

Percutaneous radiologic drainage of pancreatic abscesses. / Vansonnenberg, Eric; Wittich, Gerhard R.; Chon, Kenneth S.; D'Agostino, Horacio B.; Casola, Giovanna; Easter, David; Morgan, Robert G.; Walser, Eric; Nealon, William H.; Goodacre, Brian; Stabile, Bruce E.

In: American Journal of Roentgenology, Vol. 168, No. 4, 1997, p. 979-984.

Research output: Contribution to journalArticle

Vansonnenberg, E, Wittich, GR, Chon, KS, D'Agostino, HB, Casola, G, Easter, D, Morgan, RG, Walser, E, Nealon, WH, Goodacre, B & Stabile, BE 1997, 'Percutaneous radiologic drainage of pancreatic abscesses', American Journal of Roentgenology, vol. 168, no. 4, pp. 979-984.
Vansonnenberg E, Wittich GR, Chon KS, D'Agostino HB, Casola G, Easter D et al. Percutaneous radiologic drainage of pancreatic abscesses. American Journal of Roentgenology. 1997;168(4):979-984.
Vansonnenberg, Eric ; Wittich, Gerhard R. ; Chon, Kenneth S. ; D'Agostino, Horacio B. ; Casola, Giovanna ; Easter, David ; Morgan, Robert G. ; Walser, Eric ; Nealon, William H. ; Goodacre, Brian ; Stabile, Bruce E. / Percutaneous radiologic drainage of pancreatic abscesses. In: American Journal of Roentgenology. 1997 ; Vol. 168, No. 4. pp. 979-984.
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AU - Vansonnenberg, Eric

AU - Wittich, Gerhard R.

AU - Chon, Kenneth S.

AU - D'Agostino, Horacio B.

AU - Casola, Giovanna

AU - Easter, David

AU - Morgan, Robert G.

AU - Walser, Eric

AU - Nealon, William H.

AU - Goodacre, Brian

AU - Stabile, Bruce E.

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N2 - OBJECTIVE. The purpose of our study was to review and report the patient selection, techniques, and results of percutaneous drainage of pancreatic abscesses by retrospective review. MATERIALS AND METHODS. Fifty-nine patients (46 men and 13 women) with a mean age of 44 years old had 80 pancreatic abscesses that were drained percutaneously under radiologic guidance (CT, n = 77; sonography, n = 2; and fluoroscopy, n = 1). Abscesses had a wide spectrum of causes, with alcoholic pancreatitis being most common, trauma second most common, and gall-stones third. Ten patients had undergone surgery for pancreatic necrosis or abscess. Patients with pancreatic pseudocysts, necrosis, or acute fluid collections were excluded from this study. RESULTS. Of the 59 patients 51 (86%) were cured with percutaneous drainage and antibiotic therapy. Of the patients who were not cured with percutaneous drainage, seven required surgery and one underwent repeat percutaneous drainage. In the 59 patients, complications included non-life-threatening bleeding in three patients. Ten of 59 patients (17%) had fistulas that spontaneously formed into the gastrointestinal tract. The duration of catheterization ranged from 4 to 119 days, with a mean duration of 33 days. The rate of mortality at 30 days after completion of percutaneous drainage was 8% (5 of 59). CONCLUSION. Percutaneous drainage was an effective therapy for this defined group of patients with pancreatic abscesses. Factors leading to the relatively high success rate described in this study likely included selection of patients; catheters of adequate size, number, and location; careful follow-up with appropriate catheter manipulations; and an integrated, cooperative approach whereby surgeons were willing to permit drainage to effect its benefits rather than operating prematurely.

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