Related Experiment Video
Updated: Mar 7, 2026
Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Proactive Versus Standard Percutaneous Catheter Drainage for Infected Necrotizing Pancreatitis
Janneke van Grinsven1, Pieter Timmerman, Krijn P van Lienden
1From the *Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam; †Department of Surgery, St Antonius Hospital, Nieuwegein; ‡Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen; §Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam; ∥Department of Surgery, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam; and ¶Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Objectives:
Percutaneous catheter drainage (PCD) is often the first invasive treatment step for infected necrotizing pancreatitis. A proactive PCD strategy, including frequent and early drain revising and upsizing, may reduce the need for surgical necrosectomy and could improve outcomes, but data are lacking.
Methods:
Necrotizing pancreatitis patients were identified from in-hospital databases (2004-2014). Patients with primary PCD for infected necrotizing pancreatitis were included. Outcomes of patients from 1 center using a proactive PCD strategy were compared with 3 standard strategy centers.
Results:
In total, 369 (25.9%) of 1427 patients received a diagnosis of necrotizing pancreatitis, and 117 (31.7%) of 369 patients underwent primary PCD for infected necrosis: 42 in the proactive group versus 75 in the standard group. Patients in the proactive group had more drain-related procedures (median, 3; interquartile range [IQR], 2-4; versus 2; IQR, 1-2; P < 0.001) and larger final drain sizes (median, 16F; IQR, 14F-20F; versus 14F; IQR, 12F-14F; P < 0.001). Fewer patients underwent additional necrosectomy in the proactive group, 12 (28.6%) versus 39 (52.0%) (adjusted odds ratio, 0.349; 95% confidence interval, 0.137-0.889; P = 0.027), with similar hospital stay and mortality.
Conclusions:
A proactive PCD strategy is associated with reduced need for necrosectomy in infected necrotizing pancreatitis, compared with standard PCD, with similar clinical outcomes.
More Related Videos
04:01Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
Published on: September 8, 2022
05:42Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:22Aneurysm IV: Nursing Management
01:28Acute Pyelonephritis II: Diagnostic Studies and Management