Study of Evaluation and Management of Pancreatic Collections

Aims: To evaluate patients with pancreatitis for early identification of pancreatic fluid collections (PFCs), analyze clinical presentations, and assess the efficacy of various diagnostic and management modalities to reduce morbidity and mortality. Methods: A clinical study of 100 hemodynamically stable patients (aged 18–70 years) with PFCs was conducted at Civil Hospital, Ahmedabad, from March 2022 to March 2024. Evaluation included clinical features, biochemical tests (CBC, LFT, RFT, amylase, lipase), and radiological imaging (USG and CECT). Collections were classified per the Revised Atlanta Classification. Management involved conservative observation for asymptomatic cases and invasive drainage (surgical, percutaneous, or endoscopic) for symptomatic patients. Results: PFCs were most prevalent in males (87%) and the 41–60 age group (54%). Alcohol was the leading etiology (70%). Acute Peripancreatic Fluid Collection (APFC) was the most frequent type (39%). CECT showed superior diagnostic accuracy (76.6%) compared to USG (50%) in identifying ductal communication. Therapeutic success was highest with endoscopic drainage (80%), which also yielded the shortest hospital stay (4 days). Open surgery had the highest complication rate (50%). Conclusion: Early identification via CECT is crucial. While many PFCs resolve with conservative care, endoscopic and percutaneous drainage are preferred over open surgery due to higher success rates, lower complications, and reduced hospitalization.