Percutaneous drainage under real-time computed tomography-fluoroscopy guidance.
OBJECTIVE
The goal of our study was to assess the use of real-time computed tomography-fluoroscopy guidance for percutaneous drainage of abnormal thoracic, abdominal, and pelvic fluid collections.


METHODS
The subjects were 32 patients who underwent 36 percutaneous computed tomography-fluoroscopy guided thoracic, abdominal, and pelvic drainage procedures to drain abscess (n=29), fluid collection after pancreatitis (n=3), lymphocyst after gynecological surgery (n=3), and the gallbladder transhepatically (n=1) between September 1997 and August 2003. The patient population was 28-86 years old and consisted of 19 men and 13 women. The drainage methods included a Seldinger's technique with a guidewire and serial dilators in every case. The procedures were guided by using a helical computed tomography scanner that provided real-time fluoroscopy reconstruction.


RESULTS
Percutaneous drainage under real-time computed tomography-fluoroscopy guidance was successfully performed in every procedure. Real-time computed tomography-fluoroscopy allowed rapid assessment of needle, guidewire, dilator, and catheter placement. The only drainage-induced complication encountered was a subcutaneous hematoma after one procedure (2.8%). No patients had serious complications. The average procedure time was 32 minutes.


CONCLUSIONS
Computed tomography-fluoroscopy is a useful method for guiding the accurate and safe drainage of abnormal thoracic, abdominal, and pelvic fluid collections.
Kato
Takeharu
T
Department of Radiology, Graduate School of Medical Science Kyoto Prefectural University of Medicine, Kyoto, Japan. tkato@koto.kpu-m.ac.jp
Yamagami
Takuji
T
Iida
Shigeharu
S
Tanaka
Osamu
O
Hirota
Tatsuya
T
Nishimura
Tsunehiko
T
D000038:Abscess / Q000209:etiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D004653:Empyema / Q000209:etiology / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome