Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage
Abstract Background Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2017-12-01
|
Series: | BMC Gastroenterology |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12876-017-0717-3 |
id |
doaj-841df846722a4dab8fac52c2ecb66a09 |
---|---|
record_format |
Article |
spelling |
doaj-841df846722a4dab8fac52c2ecb66a092020-11-25T03:26:57ZengBMCBMC Gastroenterology1471-230X2017-12-011711810.1186/s12876-017-0717-3Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainagePi Liu0Jun Song1Hua-jing Ke2Nong-hua Lv3Yin Zhu4Hao Zeng5Yong Zhu6Liang Xia7Wen-hua He8Ji Li9Xin Huang10Yu-peng Lei11Department of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang UniversityAbstract Background Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the efficacy of double-catheter lavage in combination with percutaneous flexible endoscopic debridement after PCD failure is unknown compared with surgical necrosectomy. Methods A total of 27 cases of IPN patients with failure PCD between Jan 2014 and Dec 2015 were enrolled in this retrospective cohort study. Fifteen patients received double-catheter lavage in combination with percutaneous flexible endoscopic debridement, and 12 patients underwent open necrosectomy. The primary endpoint was the composite end point of major complications or death. The secondary endpoint included mortality, major complication rate, ICU admission length of stay, and overall length of stay. Results The primary endpoint occurrence rate in double-catheter lavage in combination with percutaneous flexible endoscopic debridement group (8/15, 53%) was significantly lower than that in open necrosectomy group (11/12, 92%) (RR = 1.71, 95% CI = 1.04 – 2.84, P < 0.05). Though the mortality between two groups showed no statistical significance (0% vs. 17%, P = 0.19), the rate of new-onset multiple organ failure and ICU admission length of stay in the experimental group was significantly lower than that in open necrosectomy group (13% vs. 58%, P = 0.04; 0 vs. 17, P = 0.02, respectively). Only 40% of patients required ICU admission after percutaneous debridement, which was markedly lower than the patients who underwent surgery (83%; P < 0.05). Conclusions Double-catheter lavage in combination with percutaneous flexible endoscopic debridement showed superior effectiveness, safety, and convenience in patients with IPN after PCD failure as compared to open necrosectomy.http://link.springer.com/article/10.1186/s12876-017-0717-3Infected pancreatic necrosisDouble-catheter lavagePercutaneous flexible endoscopic debridementPercutaneous catheter drainageOpen necrosectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pi Liu Jun Song Hua-jing Ke Nong-hua Lv Yin Zhu Hao Zeng Yong Zhu Liang Xia Wen-hua He Ji Li Xin Huang Yu-peng Lei |
spellingShingle |
Pi Liu Jun Song Hua-jing Ke Nong-hua Lv Yin Zhu Hao Zeng Yong Zhu Liang Xia Wen-hua He Ji Li Xin Huang Yu-peng Lei Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage BMC Gastroenterology Infected pancreatic necrosis Double-catheter lavage Percutaneous flexible endoscopic debridement Percutaneous catheter drainage Open necrosectomy |
author_facet |
Pi Liu Jun Song Hua-jing Ke Nong-hua Lv Yin Zhu Hao Zeng Yong Zhu Liang Xia Wen-hua He Ji Li Xin Huang Yu-peng Lei |
author_sort |
Pi Liu |
title |
Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
title_short |
Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
title_full |
Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
title_fullStr |
Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
title_full_unstemmed |
Double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
title_sort |
double-catheter lavage combined with percutaneous flexible endoscopic debridement for infected pancreatic necrosis failed to percutaneous catheter drainage |
publisher |
BMC |
series |
BMC Gastroenterology |
issn |
1471-230X |
publishDate |
2017-12-01 |
description |
Abstract Background Infected pancreatic necrosis (IPN) is a serious local complication of acute pancreatitis, with high mortality. Minimally invasive therapy including percutaneous catheter drainage (PCD) has become the preferred method for IPN instead of traditional open necrosectomy. However, the efficacy of double-catheter lavage in combination with percutaneous flexible endoscopic debridement after PCD failure is unknown compared with surgical necrosectomy. Methods A total of 27 cases of IPN patients with failure PCD between Jan 2014 and Dec 2015 were enrolled in this retrospective cohort study. Fifteen patients received double-catheter lavage in combination with percutaneous flexible endoscopic debridement, and 12 patients underwent open necrosectomy. The primary endpoint was the composite end point of major complications or death. The secondary endpoint included mortality, major complication rate, ICU admission length of stay, and overall length of stay. Results The primary endpoint occurrence rate in double-catheter lavage in combination with percutaneous flexible endoscopic debridement group (8/15, 53%) was significantly lower than that in open necrosectomy group (11/12, 92%) (RR = 1.71, 95% CI = 1.04 – 2.84, P < 0.05). Though the mortality between two groups showed no statistical significance (0% vs. 17%, P = 0.19), the rate of new-onset multiple organ failure and ICU admission length of stay in the experimental group was significantly lower than that in open necrosectomy group (13% vs. 58%, P = 0.04; 0 vs. 17, P = 0.02, respectively). Only 40% of patients required ICU admission after percutaneous debridement, which was markedly lower than the patients who underwent surgery (83%; P < 0.05). Conclusions Double-catheter lavage in combination with percutaneous flexible endoscopic debridement showed superior effectiveness, safety, and convenience in patients with IPN after PCD failure as compared to open necrosectomy. |
topic |
Infected pancreatic necrosis Double-catheter lavage Percutaneous flexible endoscopic debridement Percutaneous catheter drainage Open necrosectomy |
url |
http://link.springer.com/article/10.1186/s12876-017-0717-3 |
work_keys_str_mv |
AT piliu doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT junsong doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT huajingke doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT nonghualv doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT yinzhu doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT haozeng doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT yongzhu doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT liangxia doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT wenhuahe doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT jili doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT xinhuang doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage AT yupenglei doublecatheterlavagecombinedwithpercutaneousflexibleendoscopicdebridementforinfectedpancreaticnecrosisfailedtopercutaneouscatheterdrainage |
_version_ |
1724590313849225216 |