Role of percutaneous catheter drainage as primary treatment of necrotizing pancreatitis

Background/Aims: Necrotizing pancreatitis has morbidity and mortality rates exceeding most of the other acute medical emergencies despite the best possible medical and surgical care.Early surgical intervention has a high operative risk. Materials and Methods:This prospective open-label study was designed to evaluate the role of percutaneous catheter drainage (PCD) of pancreatic necrosis as primary treatment of acute necrotizing pancreatitis.An ultrasound/computed tomography-guided drainage was performed with 10 or 12 Fr catheters using a 0.35 mm guide wire, irrespective of whether necrosis was infected or not.Patients were followed up for organ dysfunction, need for surgical intervention, and survival at week 8. Results: A total of 20 (65% males) patients who had acute necrotizing pancreatitis with varied etiology were enrolled in the present study.Of these patients, 9 (45%) did not need surgery after PCD.The remaining 11 (55%) patients showed significant reversal of organ failure after PCD insertion (p<0.05 for improvement in serum creatinine, need for mechanical ventilation, and decline in C-reactive protein).Survival at week 8 was 95%.PCD was well tolerated with only two catheter-related complications being observed.Conclusion: Percutaneous catheter drainage can be a primary treatment option for necrotizing pancreatitis.In addition, it helps to stabilize critically ill patients and delay the surgical procedure to beyond 4 weeks to improve the surgical outcomes.