Efficacy, Feasibility, and Safety of Percutaneous Image-Guided Catheter Drainage of Thoracic, Abdominal, and Pelvic Fluid Collections.

Abstract

Background – Image-guided percutaneous catheter drainage (PCD) using a pigtail catheter bridges the gap between non-invasive and invasive surgical intervention with minimally invasive, image-guided drainage. This study aims to evaluate the efficacy, feasibility, safety, and relevant clinical outcomes of image guided PCD of thoracic, abdominal, and pelvic fluid collections. It also aims to assess the causes of complications and failure associated with PCD. Methods – This prospective analysis of 83 patients with abdominal, thoracic, or pelvic fluid collections was conducted by categorizing patients into three groups of intervention namely – group A (intermittent needle aspiration (INA) and PCD in the same sitting), group B (INA followed by PCD after a 48-hour interval gap), and group C (INA and PCD followed by open surgical drainage). Outcomes were measured in terms of statistical analysis, complications, residual collection, success, and failure rates of the procedure. Results – Abdomen was the most frequently encountered site of fluid collection (61.45%), CT was the most utilized modality for image guidance (61.45%), and fluid drained was most frequently purulent (57.83%). Majority of the patients were categorized into group B (57.83%), followed by group A (38.53%), and group C (3.61%). Pain at the catheter insertion site was the most commonly reported complication (72.23%). Group A and Group B showed a success rate of 93.7% and 97.9% respectively. Conclusion – In our study, image-guided PCD proved to be a time saving and efficient intervention, making it an intervention of choice in a variety of fluid collections/abscesses. INA should be considered as an initial step of management for fluid drainage, which provides an access pathway for catheter placement for PCD.