Open AccessChange in serum levels of inflammatory markers reflects response of percutaneous catheter drainage in symptomatic fluid collections in patients with acute pancreatitis
Author(s) -
Mallick Bipadabhanjan,
Tomer Shallu,
Arora Sunil K,
Lal Anupam,
Dhaka Narendra,
Samanta Jayanta,
Sinha Saroj K,
Gupta Vikas,
Yadav Thakur Deen,
Kochhar Rakesh
Publication year - 2019
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12158
Subject(s) - medicine , acute pancreatitis , percutaneous , gastroenterology , c reactive protein , sepsis , pancreatitis , procalcitonin , acute phase protein , inflammatory response , surgery , inflammation
Background Percutaneous catheter drainage (PCD) is used as the first step in the management of symptomatic fluid collections in patients with acute pancreatitis (AP). There are limited data on the effect of PCD on inflammatory markers. Aim To study the effects of PCD on serum levels of C‐reactive protein (CRP), IL‐6, and IL‐10 and its correlation with the outcome. Methods Consecutive patients of AP with symptomatic fluid collections undergoing PCD were evaluated for serum levels of CRP, IL‐6, and IL‐10 before PCD and at 3 and 7 days after PCD. Resolution of organ failure (OF), sepsis, and pressure symptoms was considered to demonstrate the success of PCD. Changes in levels following PCD were correlated with outcome. Results Indications of PCD in 59 patients (age 38.9 ± 13.17 years, 49 male) were suspected/documented infected pancreatic necrosis ( n = 45), persistent OF ( n = 40), and pressure symptoms ( n = 7). A total of 49 (83.1%) patients improved with PCD, five patients required surgery, and six died. A significant difference was noted between baseline levels of CRP ( P = 0.026) and IL‐6 ( P = 0.013) among patients who improved compared to those who worsened following PCD. Significant decrease ( P < 0.01) of all three markers on day 3 of PCD insertion, with further decrease ( P < 0.01) on day 7, was noted. The percentage of the decrease of IL‐6 levels on day 3 and of CRP on day 7 correlated with the outcome. Conclusion PCD is associated with a significant decrease in CRP, IL‐6, and IL‐10 levels. Percentage decrease in IL‐6 on day 3 and CRP on day 7 correlated with the outcome of patients managed with PCD.