Outcomes Following Image Guided Peripancreatic Fluid Drainage in Pancreas Transplantation Patients

Purpose To determine the clinical outcomes of percutaneous drainage of peripancreatic collections following pancreas transplantation.

Materials and Methods A retrospective review of patients who underwent drainage of peripancreatic fluid collections following pancreatic transplantation between November 2000 and August 2017 was performed. Thirty-one patients underwent percutaneous drainage catheter placement (68% male; median age 45 years, range: 30–52). Patient demographics, surgical technique, microbiology analysis, and clinical outcomes were reviewed.

Results The median time between pancreas transplantation and percutaneous drainage was 280 days (range, 8–3,401 days). The peripancreatic drains were left in place for a median of 28 days (range, 4–226 days). Microbiology analysis of fluid collections revealed growth in 16 (51%) of 31 patients, with Escherichia coli being the most common organism. Clinical success, as defined by resolution of the fluid collection and preservation of the pancreatic allograft, was achieved in 26 (84%) of 31 patients. Despite percutaneous drainage, five (16%) patients required pancreatectomy. Three of these five patients had a subjacent peritoneal abscess collection, which might have led to drainage failure. No procedurally related adverse events occurred. There was no significant difference in age or gender between patients with clinical success and failure.

Conclusion Percutaneous drainage is an effective technique for the treatment of peripancreatic fluid collections following pancreas transplantation, maintaining graft function, and reducing the need for surgical intervention.