The Efficacy of Trocar-Assisted Percutaneous Abscess Drainage for Patients with Severe Acute Pancreatitis Complicated by Infected Pancreatic Necrosis

Backgrounds: Traditional percutaneous catheter drainage (PCD) does not always achieve satisfactory therapeutic effects in patients with severe acute pancreatitis (SAP) complicated by infected pancreatic necrosis (IPN). We modified the conventional PCD therapy by employing Trocar-assisted percutaneous abscess drainage (TA-PAD) combined with double-lumen catheter negative-pressure irrigation and drainage for the treatment of patients with SAP with IPN and compared its efficacy with that of traditional PCD. Patients and Methods: Retrospective analysis of clinical data from patients with SAP complicated with IPN at Jinling Hospital between June 2018 and February 2024. Patients were divided by procedure into two treatment groups: the modified TA-PAD with negative-pressure irrigation group and the conventional PCD group, for comparative efficacy analysis. Results: Among the 74 patients, Comparison between the TA-PAD (n = 48) and PCD (n = 26) groups confirmed that TA-PAD was superior, yielding a lower mortality rate (12.5% vs. 34.6%, p = 0.024), shorter hospitalization (p = 0.006), reduced costs (p = 0.01), fewer re-interventions (20.8% vs. 57.7%, p < 0.001), and fewer catheters required (1 (1–2) vs. 2 (1–2.25), p = 0.029). Furthermore, the TA-PAD group demonstrated more significant improvements in infection markers, including body temperature, C-reactive protein, and white blood cell count. Conclusion: The modified TA-PAD procedure combined with double-lumen catheter negative-pressure irrigation and drainage significantly outperformed conventional PCD in treating patients with SAP with IPN. The study demonstrates significant reductions in mortality, hospital stay, treatment costs, and procedural burden, alongside a superior resolution of infection markers within one week post-intervention.