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Observational Study
. 2022 Jun;37(6):1421-1428.
doi: 10.1007/s00384-022-04183-x. Epub 2022 May 23.

High complication rate in Crohn's disease surgery following percutaneous drainage of intra-abdominal abscess: a multicentre study

Valerio Celentano  1   2   3 , Mariano Cesare Giglio  4 , Gianluca Pellino  5 , Matteo Rottoli  6   7 , Gianluca Sampietro  8 , Antonino Spinelli  9   10 , Francesco Selvaggi  5 ; Italian Society of Colorectal Surgery SICCR
Collaborators, Affiliations
Observational Study

High complication rate in Crohn's disease surgery following percutaneous drainage of intra-abdominal abscess: a multicentre study

Valerio Celentano et al. Int J Colorectal Dis. 2022 Jun.

Abstract

Introduction: Intra-abdominal abscesses complicating Crohn's disease (CD) present an additional challenge as their presence can contraindicate immunosuppressive treatment whilst emergency surgery is associated with high stoma rate and complications. Treatment options include a conservative approach, percutaneous drainage, and surgical intervention. The current multicentre study audited the short-term outcomes of patients who underwent preoperative radiological drainage of intra-abdominal abscesses up to 6 weeks prior to surgery for ileocolonic CD.

Methods: This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing ileocolic resection for primary or recurrent CD from June 2018 to May 2019. The outcomes of patients who underwent radiological guided drainage prior to ileocolonic resection were compared to the patients who did not require preoperative drainage. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes.

Results: Amongst a group of 575 included patients who had an ileocolic resection for CD, there were 36 patients (6.2%) who underwent abscess drainage prior to surgery. Postoperative morbidity (44.4%) and anastomotic leak (11.1%) were significantly higher in the group of patients who underwent preoperative drainage.

Conclusions: Patients with Crohn's disease who require preoperative radiological guided drainage of intra-abdominal abscesses are at increased risk of postoperative morbidity and septic complications following ileocaecal or re-do ileocolic resection.

Keywords: Colorectal surgery; Crohn’s disease; Inflammatory bowel disease; Intra-abdominal abscess.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

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