Predicting Factors for Failure of Percutaneous Drainage of Postoperative Intra-Abdominal Collection

Chinnarat Bua-ngam MD*, Phanloet Waeosak MD*, Banjongsak Wedsart MD*, Tharintorn Treesit MD*, Orapin Chansanti MD* Tanapong Panpikoon MD*, Jiemjit Tapaneeyakorn MD*

Affiliation : * Vascular and Body Interventional Radiology Unit, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Objective : To determine the predictive factors for failure of percutaneous drainage (PD) of postoperative intra-abdominal collection, to better select the patients who might benefit from PD. Material and Method: From September 2011 to February 2013, the authors reviewed 42 patients with symptomatic post- operative intra-abdominal collection who had received PD at Ramathibodi Hospital. The PD was considered as failure when clinical sepsis persisted or subsequent surgery was needed. Univariate analysis was used to examine the relationships between failure of PD and the collection and drainage-related variables.
Results : The success rate of PD in the present study was 80%. No major complication was detected. The overall mortality was 12%. Univariate analysis showed that the presence of biliary fistula (p = 0.012), subhepatic location (p = 0.040) and the drainage catheter size of 12F (p = 0.002) were significant predictive variables for failure of PD.
Conclusion : Image-guided PD of postoperative intra-abdominal collection was found to be a safe and effective procedure with few complications. Initial recognition of biliary fistula in the collection at subhepatic region or in patients underwent hepatobiliary surgery was the important prognostic factor for unsuccessful PD. These patients may be more beneficial for initial surgical drainage.

Keywords : Percutaneous drainage, post-operative intra-abdominal collection, predicting factors

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