Efficacy of Early Percutaneous Catheter Drainage in Acute Pancreatitis of Varying Severity Associated With Sterile Acute Inflammatory Pancreatic Fluid Collection
Efficacy of Early Percutaneous Catheter Drainage in Acute Pancreatitis of Varying Severity Associated With Sterile Acute Inflammatory Pancreatic Fluid Collection
复制标题
早期经皮导管引流对不同严重程度的急性胰腺炎与无菌急性炎症性胰液收集相关的疗效
DOI：
10.1097/mpa.0000000000001666
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Ting-Bo Liang
中科院分区：
文献类型：
--
作者：
Yun Zhang;Wen-Qiao Yu;Jian Zhang;Shui-Qiao Fu;Qing-Hui Fu;Ting-Bo Liang
目的：本研究的目的是评估不同严重程度的急性胰腺炎（AP）早期经皮导管引流（PCD）对无菌急性炎症胰液收集（AIPFC）的疗效。方法：根据2012年修订的亚特兰大分类，根据无菌AIPFC的存在和不同AP严重程度进行回顾性分析。结果：早期PCD有助于明显降低手术率（OR，P = 0.006）和感染率（IR，P = 0.020）和严重 AP（SAP）的死亡率（P = 0.009）。然而，在具有无菌 AIPFC 的中度 SAP 中，早期 PCD 与 OR (P = 0.009) 和 IR (P = 0.040) 增加相关。亚组分析显示，早期 PCD 导致 3 天内持续性器官衰竭 (OF) 患者的 OR 显着下降（单发 OF 患者的 P = 0.024，多发 OF 患者的 P = 0.039）和多发 OF 患者的死亡率（3 天内 OF 患者的 P = 0.041，3-14 天内 P = 0.055）。此外，早期 PCD 诱导感染的 SAP 患者死亡率低于自发感染 (P = 0.027)。结论：早期 PCD 可以通过降低 OR、IR 和死亡率来改善可引流无菌 AIPFC 的 SAP 预后。
Objective: The aim of the study was to evaluate the efficacy of early percutaneous catheter drainage (PCD) for sterile acute inflammatory pancreatic fluid collection (AIPFC) in acute pancreatitis (AP) of varying severity..Methods: Retrospective analyses were performed based on the presence of sterile AIPFC and different AP severities according to 2012 Revised Atlanta Classification..Results: Early PCD contributed to obvious decreases in operation rate (OR, P = 0.006), infection rate (IR, P = 0.020), and mortality (P = 0.009) in severe AP (SAP). In moderate SAP with sterile AIPFCs, however, early PCD was associated with increased OR (P = 0.009) and IR (P = 0.040). Subgroup analysis revealed that early PCD led to remarkable decreases in OR for patients with persistent organ failure (OF) within 3 days (P = 0.024 for single OF, P = 0.039 for multiple OF) and in mortality for patients with multiple OF (P = 0.041 for OF within 3 days and P = 0.055 for 3-14 days). Moreover, lower mortality was found in SAP patients with early PCD-induced infections than with spontaneous infections (P = 0.027)..Conclusions: Early PCD may improve the prognosis of SAP with drainable sterile AIPFCs by reducing the OR, IR, and mortality.