Minimally invasive procedures to treat infected necrotizing pancreatitis are gaining popularity.
The proportion of patients suitable for this approach remains unknown.
Dr Besselink and colleagues from the Netherlands reviewed preoperative computed tomography scans from 106 consecutive patients.
The patients had surgery for infected necrotizing pancreatitis between 2000 and 2003 in 11 Dutch hospitals.
|Placement of a drain was deemed feasible in 84% of patients|
|British Journal of Surgery|
The team classified collections related to the pancreas according to their distance from the left abdominal wall.
The researchers reported that 5 radiologists judged ‘accessibility' for drain placement and the likelihood that there was a fluid component that would drain.
Agreement between radiologists was determined.
The team obtained computed tomography scans of 80 patients, of which 59 were men with an age range of 29 to 80 years.
The researchers found that the median interval between hospital admission and preoperative computed tomography scan was 20 days.
The team found that in 69% of patients, the lateral border of the collection was less than 5 cm from the left abdominal wall.
Placement of a drain was deemed feasible in 84% of patients.
The researchers found that in 56% of patients, a drain could be placed through the left retroperitoneum.
In 54% of patients, collections were judged to contain a drainable fluid component.
Dr Besselink's team concluded, "Interobserver agreement on ‘drainability' was poor."
"Most peripancreatic collections in infected necrotizing pancreatitis were considered accessible to a minimally invasive approach."