Ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy: a mini-invasive strategy for peripancreatic necrotizing infection / 中华外科杂志
Chinese Journal of Surgery
; (12): 1630-1633, 2008.
Article
em Zh
| WPRIM
| ID: wpr-275964
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To establish "an integrative therapy" of drainage and debridement on peripancreatic necrotizing infection (PPNI) with minimally invasive technique, and to detect its clinical effects.</p><p><b>METHODS</b>There were 17 patients who accepted ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy from March 2006 to January 2008. Percutaneous puncture and catheter (6 - 8 F) drainage were adopted on the patients suffering from PPNI with B-us guidance, then the drainage sinus was expanded progressively from 8 F to 24 F in diameter with Cook fascia dilator by degrees, and the 22 F or 24 F tube was easily placed into the interior of PPNI instead of the prior catheter. So a better drainage effect was achieved. One week later, the necrotizing tissue of PPNI could be observed and debrided with choledochoscope under a directly-viewed way through the enlarged new sinus. Thus, with the continuous tube drainage and repeated debridement, the focus was absorbed and covered gradually.</p><p><b>RESULTS</b>Seventeen cases accepted the mini-invasive therapy, 15 cases were saved finally with cure rate of 88.2%, and 2 cases conversion to laparotomy because of some technical reasons. The mean healing time was 73 days, and the mean hospitalization time was 57 days. Bleeding was occurred in 2 cases localized in sinus and the inside of PPNI, digestive tract fistula was detected in 2 cases, and these patients with the complications were cured under nonoperative management. All the patients were still alive with following-up, neither remains nor recurrence of the PPNI was found in our group.</p><p><b>CONCLUSIONS</b>Ultrasound-guided percutaneous tube drainage combined with directly-viewed debridement with cholangioscopy, as a mini-invasive therapy, could complete the goal-directed therapy of PPNI, meanwhile, realize the modern surgery ideal of damage control.</p>
Texto completo:
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Base de dados:
WPRIM
Assunto principal:
Pancreatopatias
/
Patologia
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Cirurgia Geral
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Drenagem
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Endoscopia do Sistema Digestório
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Procedimentos Cirúrgicos Minimamente Invasivos
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Pancreatite Necrosante Aguda
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Desbridamento
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Infecções
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Métodos
Tipo de estudo:
Guideline
Idioma:
Zh
Revista:
Chinese Journal of Surgery
Ano de publicação:
2008
Tipo de documento:
Article