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Ultrasound—guided percutaneous catheter drainage in early treatment of severe acute pancreatitis.doc

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Ultrasound—guided percutaneous catheter drainage in early treatment of severe acute pancreatitis

Ultrasound—guided percutaneous catheter drainage in early treatment of severe acute pancreatitis BACKGROUND： Percutaneous catheter drainage （PCD） is a minimally invasive intervation for severe acute pancreatitis （SAP）. This study was undertaken to compare the results of surgery and ultrasound-guided PCD in the treatment of 32 patients with SAP， and to direct clinicians to the most optimal approach for SAP. METHODS： In the 32 patients， 19 were proved to have deteriorated clinical signs or symptoms， extensive fluid exudation， and necrosis confirmed by computed tomography （CT） and they underwent operative debridement and drainage. For extensive fluid exudation or necrosis， complete liquefaction and safe catheter implantation， the other 13 patients were given PCD. RESULTS： The mortality rate of the surgery group was 26.3%， much higher than that of the PCD group （0%）. There was a significant difference between the two groups （P=0.044）. The mean time for recovery of the serum C-reactive protein （CRP） level was 43.8 days in the surgery group， which was significantly longer than that of the PCD group （23.8 days）（P=0.034）. CONCLUSION： Early PCD guided by ultrasound could decrease the mortality of patients with severe acute pancreatitis， alleviate life-threatening inflammatory complications， and avoid unnecessary emergency operation. KEY WORDS： Percutaneous catheter drainage； Operation； Severe acute pancreatitis； Clinical efficacy World J Emerg Med 2010；1（1）：45-48 INTRODUCTION Percutaneous catheter drainage （PCD） was reported as a minimally invasive intervention for severe acute pancreatitis （SAP），[1] and approximately 54% of patients with acute necrotizing pancreatitis can be successfully treated with CT-guided PCD. SAP is a rapid progressive disease with a high mortality rate and a high incidence of life-threatening complications. Bai et al[2] reported that the overall mortality rate of SAP was 11.8% in China and 10%-40% in western countries.[3] B