A preliminary study on percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy in treatment of refractory liver abscess
10.3969/j.issn.1001-5256.2021.11.026
- VernacularTitle:经皮经肝穿刺引流序贯经皮肾镜治疗难治性肝脓肿的初步探讨
- Author:
Changhu DUAN
1
;
Xiaochen LIU
1
;
Jianlong DING
1
;
Jianfeng DUAN
1
;
Xirong ZHAO
1
;
Fan YANG
1
;
Ling WU
1
;
Lifei ZHAO
1
;
Sheng TAI
2
Author Information
1. Department of Hepatobiliary Surgery, The Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine, Hanzhong, Shaanxi 723000, China
2. Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
- Publication Type:Original articles_Other liver diseases
- Keywords:
Liver Abscess;
Drainage;
Endoscopy, Digestive System
- From:
Journal of Clinical Hepatology
2021;37(11):2622-2625
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy for necrosectomy and drainage in the treatment of refractory liver abscess after transcatheter arterial embolization (TACE). Methods A retrospective analysis was performed for three patients with refractory liver abscess after TACE in The Affiliated 3201 Hospital of Xi'an Jiaotong University School of Medicine from January 2018 to December 2020, and among the three patients, one had the formation of liver abscess after TACE for hepatic metastases after pancreaticoduodenectomy, one had liver abscess after repeated TACE for massive hepatocellular carcinoma, and one had secondary liver abscess after TACE for traumatic hepatic rupture. All three patients received percutaneous transhepatic drainage and sequential percutaneous nephroscopy for the treatment of refractory liver abscess, and their specific treatment process was summarized. Results All three patients were diagnosed with refractory liver abscess based on CT, routine blood test, procalcitonin, blood culture, and clinical manifestation. Percutaneous transhepatic catheterization under the guidance of conventional ultrasonography or CT and effective antibiotics had an unsatisfactory therapeutic effect, and after sequential percutaneous nephroscopy was performed for necrosectomy and drainage, liver abscess was cured and the patients had good prognosis. Conclusion For refractory liver abscess after TACE, when routine puncture treatment has an unsatisfactory therapeutic effect or a patient cannot tolerate surgical operation, percutaneous transhepatic drainage combined with sequential percutaneous nephroscopy is safe and effective in the treatment of refractory liver abscess.
