Percutaneous aspiration and drainage of abdominal fluid collections after pancreatic transplantation

Pancreatic transplantation, performed to avert or delay the long-term complications of insulin-dependent diabetes mellitus, is sometimes complicated by the development of intraabdominal fluid collections. We performed 33 sonographically guided and CT-guided percutaneous abdominal aspiration and drainage procedures in 22 transplant patients; 25 procedures were done with the pancreatic graft-in-situ, and eight were done after removal of the transplant. All 11 percutaneous aspirations performed in 10 patients were successful in obtaining microbiologic culture material, and there were no complications. Sixteen percutaneous catheter drainages were performed in 13 patients with the graft-in-situ. Subsequent surgical intervention was avoided after only five (31%) of these drainage procedures. However, further intervention was unnecessary after five (83%) of six percutaneous catheter drainages in five patients who had previously undergone transplant pancreatectomy. No significant short-term or long-term complications were identified. Guided percutaneous aspiration of abdominal fluid collections after pancreatic transplantation is a safe and effective means of obtaining diagnostic material, and guided catheter drainage is definitive treatment in approximately one-third of procedures with the graft-in-situ and in most procedures done after removal of the graft.