What is the role of image guided PCD in the treatment of infected ANC and WON?
- The role of PCD in the management of infected ANC and WON is controversial.
- Open surgical necrosectomy is still considered the gold standard treatment in infected pancreatic necrosis, because it involves nonliquefactive tissue that is difficult to remove with percutaneous drainage catheters.
- However, open necrosectomy is associated with a high mortality rate and significant morbidity.
- Image-guided PCD generally has a lower morbidity and mortality rate and can be considered in patients with appropriate percutaneous access either as potential definitive treatment or as a bridge to surgery.
- It is not uncommon for drains to be left in place for a month or longer.
- Effective percutaneous drainage also requires vigorous catheter irrigation and frequent catheter upsizing and exchange
