Background and Objective: To evaluate the clinical effectiveness of early percutaneous catheter drainage (PCD) in patients with moderately severe and severe acute pancreatitis with sterile acute inflammatory pancreatic fluid collections (AIPFCs). Methods: This prospective comparative study enrolled 32 adult patients with moderately severe or severe acute pancreatitis based on the 2012 Revised Atlanta Classification. Patients were randomized into two groups: Group 1 (n=16) underwent early ultrasound-guided PCD alongside standard care; Group 2 (n=16) received conservative management alone. Clinical parameters, severity scores, intra-abdominal pressure (IAP), enzyme levels, and outcomes were analyzed. Results: Baseline BISAP and SOFA scores were comparable between the groups. By Day 7, SOFA scores significantly improved in Group 1 (1.69?±?1.55) compared to Group 2 (3.33?±?1.35; p=0.013). IAP at Day 7 was also significantly lower in Group 1 (9.29?±?1.82 vs. 13.81?±?2.71; p=0.001). Serum amylase showed a greater reduction post-intervention in Group 1. No significant difference was observed in hospital stay duration or mortality, though Group 1 had a slightly higher mortality rate (31.2% vs. 18.8%; p=0.189). Fluid cultures were sterile in 75% of PCD patients. Conclusion: Early PCD in sterile AIPFCs may significantly reduce organ dysfunction and intra-abdominal pressure without increasing hospital stay. While not impacting overall mortality or discharge rate, PCD shows potential benefit in mitigating systemic effects of fluid collections in select patients with severe acute pancreatitis.
Vardhan et al. (Tue,) studied this question.