Change in serum levels of inflammatory markers reflects response of percutaneous catheter drainage in symptomatic fluid collections in patients with acute pancreatitis

医学 急性胰腺炎 经皮 C反应蛋白 败血症 胃肠病学 胰腺炎 内科学 降钙素原 炎症反应 坏死 急性期蛋白 全身炎症反应综合征 外科 导管 脓肿 炎症
作者
Bipadabhanjan Mallick,Shallu Tomer,Sunil Arora,Anupam Lal,Narendra Dhaka,Jayanta Samanta,Saroj K. Sinha,Vikas Gupta,Thakur Deen Yadav,Rakesh Kochhar
出处
期刊:JGH open [Wiley]
卷期号:3 (4): 295-301 被引量:15
标识
DOI:10.1002/jgh3.12158
摘要

Background Percutaneous catheter drainage (PCD) is used as the first step in the management of symptomatic fluid collections in patients with acute pancreatitis (AP). There are limited data on the effect of PCD on inflammatory markers. Aim To study the effects of PCD on serum levels of C‐reactive protein (CRP), IL‐6, and IL‐10 and its correlation with the outcome. Methods Consecutive patients of AP with symptomatic fluid collections undergoing PCD were evaluated for serum levels of CRP, IL‐6, and IL‐10 before PCD and at 3 and 7 days after PCD. Resolution of organ failure (OF), sepsis, and pressure symptoms was considered to demonstrate the success of PCD. Changes in levels following PCD were correlated with outcome. Results Indications of PCD in 59 patients (age 38.9 ± 13.17 years, 49 male) were suspected/documented infected pancreatic necrosis ( n = 45), persistent OF ( n = 40), and pressure symptoms ( n = 7). A total of 49 (83.1%) patients improved with PCD, five patients required surgery, and six died. A significant difference was noted between baseline levels of CRP ( P = 0.026) and IL‐6 ( P = 0.013) among patients who improved compared to those who worsened following PCD. Significant decrease ( P < 0.01) of all three markers on day 3 of PCD insertion, with further decrease ( P < 0.01) on day 7, was noted. The percentage of the decrease of IL‐6 levels on day 3 and of CRP on day 7 correlated with the outcome. Conclusion PCD is associated with a significant decrease in CRP, IL‐6, and IL‐10 levels. Percentage decrease in IL‐6 on day 3 and CRP on day 7 correlated with the outcome of patients managed with PCD.
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