Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 134-142
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.134
Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intra-abdominal fluid accumulation
Rui Chen, Hua-Qiang Chen, Rui-Die Li, Hui-Min Lu
Rui Chen, Hua-Qiang Chen, Rui-Die Li, Department of General Surgery, Chengdu Sixth People’s Hospital, Chengdu 610058, Sichuan Province, China
Hui-Min Lu, West China Center of Exellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University; Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen R, Chen HQ, Li RD, and Lu HM designed the research study; Chen R and Chen HQ performed the research; Li RD contributed new reagents and analytic tools; Chen R, Li RD and Lu HM analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Chengdu No. 6 People's Hospital.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Min Lu, MD, Assistant Professor, Associate Chief Physician, Surgeon, West China Center of Exellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University; Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. hm.lu@scu.edu.cn
Received: November 10, 2023
Peer-review started: November 10, 2023
First decision: November 22, 2023
Revised: November 28, 2023
Accepted: December 15, 2023
Article in press: December 15, 2023
Published online: January 27, 2024
ARTICLE HIGHLIGHTS
Research background

Severe acute pancreatitis (SAP), a severe form of acute pancreatitis, is characterized by rapid progression, a high incidence of complications, and a high mortality rate among patients. It necessitates urgent medical intervention and treatment. While minimally invasive surgery can effectively remove necrotic tissue in SAP, it can be challenging to completely clear necrotic tissue during the early stages of SAP due to the difficulty in accurately distinguishing between normal and necrotic pancreatic tissue.

Research motivation

Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with SAP. However, there is still ongoing debate regarding the optimal timing for abdominal paracentesis catheter placement and drainage.

Research objectives

The aim of this study was to explore the application value of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumulation. This study aims to provide more precise guidance for clinicians, optimizing treatment strategies, and improving the quality of life for SAP patients.

Research methods

Through a retrospective study design, 184 cases of SAP complicated by intra-abdominal fluid accumulation were selected from patients treated at our hospital from August 2022 to July 2023. These cases were categorized into three groups based on the timing of catheter placement: Group A (catheter placement within 2 d of symptom onset, n = 89), group B (catheter placement between days 3 and 5 after symptom onset, n = 55), and group C (catheter placement between days 6 and 7 after symptom onset, n = 40). Differences in progression rate, mortality rate, and the number of cases with organ dysfunction were then compared between the three groups.

Research results

The progression rate and proportion of patients with at least one organ dysfunction in group A was significantly lower than those in group B and group C. At postoperative day 3, the levels of C-reactive protein, procalcitonin, tumor necrosis factor-alpha, interleukin-6, interleukin-8, and serum amyloid A were significantly lower in group A compared with those observed in groups B and C. The length of hospital stay and hospitalization expenses in group A were also significantly lower than those in groups B and C. The incidence of complications in group A was markedly lower than that in group C, and similar to group B (P > 0.05).

Research conclusions

Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is more effective when performed within 2 d of onset.

Research perspectives

Prospective study with large cohort is required.