Diagnosis,treatment and etiology of hepatic infarction and abscess after pancreaticoduodenal surgery
10.19538/j.cjps.issn1005-2208.2019.06.18
- Author:
Qiang XU
1
;
Meng-hua DAI
1
;
Yu-pei ZHAO
1
Author Information
1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medial Sciences Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
pancreaticoduodenectomy;
hepatic infarction;
hepatic abscess;
hepatic artery injury
- From:
Chinese Journal of Practical Surgery
2019;39(06):599-605
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To explore the causes and treatment of hepatic infarction and abscessafter pancreaticoduodenal surgery.METHODS: The clinical data of 11 cases of hepatic infarction or abscess after pancreaticoduodenal surgery in Peking Union Medical College Hospital between January 2012 and December 2018 were analyzed retrospectively.RESULTS: A total of 11 patients were diagnosed of hepatic infarction or abscess after PD.The overall mortality rate was27.3%(3 of 11 patients).54.5%(6/11)had biliary fistula.Of the 11 patients,7 had proper hepatic artery and right accessory hepatic artery occlusion or stenosis,1 had abdominal trunk root stenosis before operation,and 3 had PV stenosis.Enterococcus and Klebsiella were the organisms most frequently cultured,and fungi were also the common pathogens.Antibiotics and selective percutaneous drainage were the main means of treatment.CONCLUSION: Ischemia of hepatic artery and portal vein after PD is the main cause of liver infarction and liver abscess.Biliary fistula and multiple pathogenic bacteria are often associated with high mortality.
