Abstract
Background
To study the frequency and outcomes of percutaneous imaging-guided drainage following pancreaticoduodenectomy and to assess if fluid collection location correlates with pancreatic duct leak.
Methods
IRB approval was obtained. Three hundred and seventy-three subjects (age 21–84 years) who underwent pancreaticoduodenectomy were included in this retrospective study. Eighty-three of these subjects underwent post-operative imaging-guided drainage (CT 77; US 6). Medical and imaging records were reviewed. Procedural details including collection location, size, catheter size, drain duration, fluid type, fluid chemistry, and fluid culture were recorded. Collection location was correlated with fluid amylase.
Results
The frequency of imaging-guided percutaneous drainage following Whipple was 22.2%. The immediate technical and overall success rates for fluid collection drainage were 97.6% and 79.6%, respectively. Rate of complication was 4.8% (4/83). 74.7% (62/83) of fluid collections were proven abscesses, and 61.4% (51/83) were complicated by pancreatic fistula. Collections near the pancreatic resection site were more likely to have elevated fluid amylase.
Conclusion
Approximately one-fifth of subjects requires percutaneous drainage following pancreaticoduodenectomy. Percutaneous imaging-guided drainage is an effective means of managing post-pancreaticoduodenectomy fluid collections. Collections near the pancreas resection site often have a pancreatic duct leak.
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References
Erickson, RA (2005) Pancreatic cancer. Emedicine.com. http://www.emedicine.com/med/topic1712.htm. Accessed December 15, 2005
Gervais DA, Fernandez-del Castillo C, O’Neill MJ, et al. (2001) Complications after pancreatoduodenectomy: imaging and imaging-guided interventional procedures. Radiographics 21:673–690
Cheng T, Sheth K, White RR, et al. (2006) Effect of neoadjuvant chemoradiation on operative mortality and morbidity for pancreaticoduodenectomy. Ann Surg Oncol 13(1):66–74
Goldman R, Hunter TB, Haber K (2006) The silent abdominal abscess: role of the radiologist. AJR 187:1591–1596
Beecher EE, Shires GT, Shires GT (2004) Treatment of post-pancreaticoduodenectomy complications. Curr Treat Options Gastroenterol 7(5):365–370
Suzuki Y, Fujino Y, Ajiki T, et al. (2005) No mortality among 100 consecutive pancreaticoduodenectomies in a middle-volume center. World J Surg 29(11):1409–1414
Sohn TA, Yeo CJ, Cameron JL, et al. (2003) Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications. J Gastrointest Surg 7(2):209–219
Conlon KC, Labow D, Leung D, et al. (2001) Prospective randomized clinical trial of the value of intraperitoneal drainage after pancreatic resection. Ann Surg 234(4):487–493
AAssar OS, LaBerge JM, Gordon RL, et al. (1999) Percutaneous management of abscess and fistula following pancreaticoduodenectomy. Cardiovasc Intervent Radiol 22(1):25–28
Singh AK, Gervais DA, Alhilali LM, et al. (2006) Imaging-guided catheter drainage of abdominal collections with fistulous pancreaticobiliary communication. AJR 187:1591–1596
Hashimoto M, Koga M, Ishiyama K, et al. (2007) CT features of pancreatic fistula after pancreaticoduodenectomy. AJR 188:W323–W327
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Zink, S.I., Soloff, E.V., White, R.R. et al. Pancreaticoduodenectomy: frequency and outcome of post-operative imaging-guided percutaneous drainage. Abdom Imaging 34, 767–771 (2009). https://doi.org/10.1007/s00261-008-9455-x
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DOI: https://doi.org/10.1007/s00261-008-9455-x