[Interventional ultrasound in the treatment of acute pancreatitis].

OBJECTIVE The objective of this study is to evaluate the possibilities of interventional ultrasonography in the treatment of liquid collections created during and after an acute pancreatitis. PATIENTS AND METHODS Ultra-sound controlled percutaneous drainage of peripancreatic liquid collections was done in 58 patients (44 men and 14 women, average age 47.8 within the span of 15-68) in the period between May 1995 and September 2001. Pseudocystitis of pancreas formed after an acute pancreatitis was drained in 19 cases, abscess collections were drained in 14 cases, and in 25 cases a catheter was entered in peripancreatic liquid collections and steatonecrotic masses in the initial phase of acute haemorrhagic necrotic pancreatitis. Pigtail catheters 5 to 7 F were placed to serve for drainage and instillation of medicaments. RESULTS In the group of patients to whom a catheter was placed in liquid collections and steatonecrotic masses, two lethal outcomes were recorded. However, they were not the result of the intervention, but of emboly of lungs and coagulopathy. One patient with peripancreatic abscess collections was operated after the intervention. In other patients, ultra-sound controlled percutaneous drainage was successful. Before our intervention 22 patients had been operated, five of them twice and two of them three times. CONCLUSION Ultra-sound controlled percutaneous drainage gives an important contribution in the treatment of the hardest forms of acute pancreatitis and represents a safe and less aggressive method in the treatment of liquid collections and steatonecroses formed during an acute pancreatitis.