Choledocoscopy assisted debridement for peripancreatic necrotizing infection residented after surgical drainage
10.3760/cma.j.issn.1674-1935.2011.01.003
- VernacularTitle:胰周坏死感染外引流术后的胆道镜下清创术
- Author:
Tao WANG
;
Lijun TANG
;
Bingyin ZHANG
;
Yong YAN
;
Minghui YE
;
Yongqiang ZHU
;
Hua WANG
- Publication Type:Journal Article
- Keywords:
Pancreas;
Necrosis;
Debridement;
Endoscopy,digestive system
- From:
Chinese Journal of Pancreatology
2011;11(1):5-7
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the experience of endoscopic mini-invasive therapy for residual lesions of peripancreatic necrotizing infection with choledocoscopy-assisted debridement technique, and to explore its clinical application value. Methods 71 patients with postoperative surgical drainage and accompanied with residual focus were collected. Choledochoscope was inserted via the drainage sinus, and the focus was observed and necrotic tissue was removed under direct choledochoscopic vision. Results Of the 71 patients who underwent this procedure, 64 were cured (success rate, 90.1%); 3 patients withdraw from treatment due to economic reasons; 4 patients received open surgery after 1 ～ 3 times of choledocoscopy-assisted debridement. The 64 cured patients received 2 ～ 9 times of choledocoscopy-assisted debridement with a mean of 5.1 times. 87.5% patients needed 4 ～ 6 times of procedures. The healing time was 18 ～ 125 days (average 71.3 days). Hemorrhage occurred in 3 patients and digestive tract fistula occurred in 2 patients and were resolved with non-operative management. Conclusions With the help of postoperative established surgical drainage channel, choledochoscopy-assisted debridement could be considered as a safe and effective miniinvasive treatment for residual focus of peripancreatic necrotizing infection, and is worth of clinical application.
