Treatment of parapancreatic abscess with debridement by choledochoscope in combination with percutancous puncture drainage under ultrasound guidance: an analysis of 36 cases

VernacularTitle:胰周脓肿经超声介入穿刺联合胆道镜清创治疗36例经验总结
Author: Yong YAN ; Ruiwu DAI ; Tao WANG ; Lijun TANG ; Bingyin ZHANG
Publication Type:Journal Article
Keywords: Parapancreatic abscess; Ultrasound intervention; Choledochoscope; Recovery rate
From: Chinese Journal of Hepatobiliary Surgery 2011;17(1):20-22
CountryChina
Language:Chinese
Abstract: Objective To explore a new method of parapancreatic abscess treatment and establish an idea of minimally invasive technologies for parapancreatic abscess to improve the recovery rate of acute pancreatitis. Methods The patients had experienced percutaneous puncture and placed drainage tube under the ultrasound guidance first, then the sinus tract was expanded gradually to 24F perimeter by Cook's fascia expender. Finally, the necrotic tissue and pyogenic membrane was removed and repeatedly washed under guidance of choledochoscopy. Results The recovery rate was 91.1 %(33/36). The complication incidence was 10.7% (hemorrage:2 cases, external intestinal fistula:3 cases, and fatal MOF: 1 case). Conclusions The viewpoint which parapancreatic abscess only can be cured by drainage operation can be changed by associating debridement by choledochoscope with percutaneous puncture drainage under the ultrasound guidance. It is a simple, safe and effective method. It can be used to reduce the patients' damage, complication and mortality and accomplish the idea of damage control by minimally invasive technologies.