Quantification of the impact of interventional radiology in the management of acute pancreatitis.

ABSTRACT

OBJECTIVES: Interventional radiology plays a central role in the management of complicated acute pancreatitis, contributing to image-guided drainages, treating haemorrhagic complications and maintaining the patency of the biliary tree. In addition, many of these patients require long-term venous access for antibiotics or parenteral feeding. The aim of this study was to evaluate the role and level of involvement of the interventional radiology in this sub-group of patients. METHODS: This was a single-centre retrospective review of all admissions for acute pancreatitis over a 5-year period. Each case was assessed to determine whether radiological intervention was utilised. RESULTS: Our review included 401 patients. A total of 18.7% (75/401) of patients required vascular access procedures and 18.4% (74/401) required image-guided drainage. A total of 1.2% (2/401) patients had embolisation procedures performed. The embolisation procedures were performed to treat a pseudoaneurysm that had formed. Overall, 20.9% (84/401) of patients were referred to the interventional radiology department for a procedure; a majority of these patients were referred for multiple procedures over the course of their admission. The patients in the 'severe pancreatitis' category had a total of 154 procedures performed, which was 65.5% of the total procedures. On average, the patients who underwent multiple interventional procedures tended to have a longer admission and more complex disease. CONCLUSION: The diagnosis and treatment of complicated acute pancreatitis is heavily dependent on the interventional radiology department. A substantial proportion of patients with pancreatitis required radiological intervention as part of their management, the proportion of which increased significantly in complex disease.