PERCUTANEOUS INTERVENTION IN ACUTE-PANCREATITIS

Interventional radiology has an important role to play in the manageme nt of local complications of acute pancreatitis, such as necrosis, pse udocyst, and abscess. Computed tomography (CT) is preferred for guidin g pancreatic interventional procedures, with the most common access ro utes being through the left anterior pararenal space for pancreatic ta il collections and through the gastrocolic ligament for pancreatic hea d and body collections. Pancreatic necrosis has a high mortality if in fected, and the presence of infection must be determined with CT-guide d needle aspiration, Careful planning of the access route is important to avoid the colon, Catheters of 8-12 F are usually sufficient for ps eudocyst drainage. An average of 2-3 weeks drainage is required if the re is no communication of the pseudocyst with the pancreatic duct and many weeks to months for pseudocysts with pancreatic duct communicatio n, Percutaneous drainage of pseudocysts is associated with success rat es of 80%-30%, Pancreatic abscess drainage has quoted success rates va rying between 32% (infected necrosis) and 90% (pancreatic abscess). Us e of large or multiple catheters is often required for complete draina ge, The management of patients with severe acute pancreatitis is time- consuming and labor intensive for interventional radiologists, and a t eam approach with close communication with surgical personnel is requi red.