The Clinical Observation Of Ultrasound-guilded Percutaneous Catheter Drainage In Treatment For Infected Necrotizing Pancreatitis

Objective:To examine the clinical value of ultrasound-guilded percutaneouscatheter drainage in treatment for infected necrotizing pancreatitis(INP).Method:Make a collection of patients with INP in China-Japan union hospitalaffiliated to Jilin university from Jan.2010to Dec.2014.Classify those patientsto PCD treatment group,PCD+surgical intervention treatment group andsurgical intervention treatment group.Make a retrospective analysis of PCD andPCD+surgical intervention to identify factors predictive of failure of PCD。Compared patients undergoing open necrosectomy with those undergoing PCDupfront,and open necrosectomy in terms of major complications includingdeath。Results: Atotal of54infected necrotizing pancreatitis included in thisretrospective analysis,According to the initial interventions can be divided intoinitial PCD group (33/54) and the initial surgical group (21/54), two groupsonly have statistical significance inAPACHEII scores on admission (6.91±3.41vs.12.17±3.23), P <0.05,Two groups have no statistical significance inage, sex, etiology, associated with disease, organ failure conditions onadmission, computed tomography (CT) severity index on admission, systemicinflammatory response syndrome on admission and necrosis range onadmission.According to traditional debridement surgery whether to join for infected necrotizing pancreatitis after PCD, initially PCD is divided into purePCD group (17/33) and PCD+surgery group (16/33).Comparing to pure PCDgroup and PCD+surgery group，we found statistically significant, P <0.05intheAPACHEII scores on admission (6.85±3.51vs11.87±3.24), pancreaticnecrosis range <30%（11/1573%vs4/1527%）, pancreatic necrosis range>50%（1/119%vs10/1191%）and pancreas central necrosis （3/1323%vs10/1377%）, in age, sex, organ failure conditions on admission, systemicinflammatory response syndrome on admission, computed tomography (CT)severity index on admission and pancreatic necrosis range between30%and50%no statistical differences.Contrast between PCD+surgery group (16/54)and simple surgical group (21/54) we found in preoperativeAPACHEII scoresbetween the two groups（6.17±2.21vs11.23±4.13）and postoperative bloodglucose6months （3/1421.43%vs10/1471.42%） was statistically difference，however found no significantly statistical differences in age, sex, organ failureconditions on admission,APACHEII scores on admission, before the operationorgan failure situation, the new organ failure after operation, postoperativecomplications and postoperative mortality.Conclusions: PCD obviates surgery and acts as a temporizing measure in asignificant number of patients with infected necrotizing pancreatitis.APACHEII scores、extent of intrapancreatic necrosis and central gland necrosis areprinciple factors determining success of PCD.PCD has some pancreaticprotection function of INP.