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David B. Adams, MD; Tracy S. Harvey, MD; Marion C. Anderson, MD

Arch Surg. 1990;125(12):1554-1557.

Abstract
• Operative drainage is the cornerstone of therapy for pancreatic abscess. Recently it has been suggested that successful percutaneous catheter drainage of infected pancreatic and peripancreatic fluid collections may serve as definitive therapy. We undertook therapeutic, computed tomography–directed percutaneous drainage in a selected group of 29 patients with infected pancreatic and peripancreatic fluid collections. Twenty-three patients (79%) were successfully treated with percutaneous drainage. Of six patients (21%) representing failures of percutaneous drainage, four died and two recovered after operative drainage. The four patients who died had a mean APACHE (acute physiology and chronic health evaluation) II score of 23 and five of Ranson's prognostic signs. Ranson's signs and APACHE II scores were predictive of success and mortality. We conclude that in selected patients, infected pancreatic and peripancreatic fluid collections can be treated definitively with therapeutic percutaneous catheter drainage. Based on this experience, recommendations regarding patient selection are included.

(Arch Surg. 1990;125:1554-1557)

Author Affiliations
From the Department of Surgery, Veterans Administration Medical Center and the Medical University of South Carolina, Charleston.

Footnotes
Accepted for publication August 24, 1990.

Read before the 14th Annual Surgical Symposium of the Association of Veterans Affairs Surgeons, Charleston, SC, May 7, 1990.

Reprint requests to Department of Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425 (Dr Adams).

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