Selection of drain diameter in initial drainage of patients with acute necrotizing pancreatitis

Objective. To evaluate the treatment outcomes of acute necrotizing pancreatitis using drains of different diameters in patients with acute necrotic accumulations. Materials and methods. From 2013 to 2018, 124 patients with acute necrotizing pancreatitis were treated using minimally invasive surgical techniques. Group 1 consisted of 56 patients who were initially given drains with a diameter of 8–16 Fr, while Group 2 consisted of 68 patients who were given drains with a diameter of 28–32 Fr. The patient groups were comparable in terms of main indicators (p > 0.05). Results. In Group 1, replacement with larger diameter drains was needed in 100% of cases, while in Group 2 it was needed in 18.7% of patients (p < 0.05). As a final treatment method, puncture-drainage technology was used in Group 1 for 31 (55.4%) patients, and in Group 2 for 57 (83.8%) (p < 0.05). The incidence of perioperative complications was 51.7% in Group 1 and 16.1% in Group 2 (p < 0.05). The duration of hospitalization in Group 1 was on average 16 ± 7.3 days longer. Mortality rate was 30.4% in Group 1 and 11.8% in Group 2 (p < 0.05). Conclusion. The use of wide-bore drains at the initial stage increases the effectiveness of puncture-drainage treatment of acute necrotizing pancreatitis and allows for a reduction in mortality rate.

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