STEP UP APPROACH IN MANAGEMENT OF ACUTE SEVERE PANCREATITIS ANALYSIS OF FACTORS RESPONSIBLE FOR FAILURE OF PER CUTANEOUS DRAINAGE.

Background: There is a paradigm shift towards minimally invasive approaches to manage local complications of acute pancreatitis specially infected necrosis. Step Up approach has been emerged during last decade to overcome the shortcomings of traditional open necrosectomy. Image-guided percutaneous drainage (PCD) is a minimally invasive intervention that helps ?to bring out heat from fire??. It is currently not possible to predict that which subgroup of patients will need necrosectomy as a result of failure of percutaneous catheter drainage. This study was done to analyze the factors predicting failure of per cutaneous drainage. Methods: This is a combined retro-prospective observational study included 42 patients with local complications of acute pancreatitis, managed at our centre during Jun 2010 to May 2017. We analyzed association between various demographic, hematological, biochemical, clinical and radiological variable predicting failure of per cutaneous drainage. Results: All 42 patients included underwent image guided per cutaneous drainage initially. Catheter drainage was successful (survival without any other additional intervention) in 13 patients (30.95%).