Choledocoscopy assisted debridement for peripancreatic necrotizing infection residented after surgical drainage

( views:261, downloads:0 )
Author:
WANG Tao(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
TANG Li-jun(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
ZHANG Bing-yin(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
YAN Yong(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
YE Ming-hui(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
ZHU Yong-qiang(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
WANG Hua(General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu 610083, China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 11, Issue 01, 2011
DOI:
10.3760/cma.j.issn.1674-1935.2011.01.003
Key Word:
Pancreas;Necrosis;Debridement;Endoscopy,digestive system

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.

  • [1]傅由池,高志清,刘正才.重症急性胰腺炎坏死组织清除的指征与方法探讨.中国实用外科杂志,2004,24:675-677.
  • [2]许元鸿,郭克建,欧阳兵,等.重症急性胰腺炎并发胰腺感染坏死和胰腺脓肿的诊断和治疗.中华普通外科杂志,2007,22:356-358.
  • [3]汪涛,汤礼军,田伏洲,等.介入超声穿刺引流联合胆道镜清创:胰周坏死感染的微创化解决方案.中华外科杂志,2008,46:1630-1633.
  • [4]Meyers MA.Uriniferous perirenal pseudocyst:new observations.Radiology,1975,117:539-545.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn