Percutaneous catheter drainage in combination with choledochoscope-guided debridement in treatment of peripancreatic infection.
OBJECTIVE
To introduce and evaluate the new method used in treatment of pancreatic and peripancreatic infections secondary to severe acute pancreatitis (SAP).


METHODS
A total of 42 SAP patients initially underwent ultrasound-guided percutaneous puncture and catheterization. An 8-Fr drainage catheter was used to drain the infected peripancreatic necrotic foci for 3-5 d. The sinus tract of the drainage catheter was expanded gradually with a skin expander, and the 8-Fr drainage catheter was replaced with a 22-Fr drainage tube after 7-10 d. Choledochoscope-guided debridement was performed repeatedly until the infected peripancreatic tissue was effectively removed through the drainage sinus tract.


RESULTS
Among the 42 patients, the infected peripancreatic tissue or abscess was completely removed from 38 patients and elective cyst-jejunum anastomosis was performed in 4 patients due to formation of pancreatic pseudocysts. No death and complication occurred during the procedure.


CONCLUSIONS
Percutaneous catheter drainage in combination with choledochoscope-guided debridement is a simple, safe and reliable treatment procedure for peripancreatic infections secondary to SAP.
Tang
Li-Jun
LJ
Center of General Surgery, Chengdu General Hospital of Chengdu Military Area Command, Chengdu 610083, Sichuan Province, China. whjtlj@yahoo.com.cn
Wang
Tao
T
Cui
Jian-Feng
JF
Zhang
Bing-Yin
BY
Li
Shi
S
Li
Dong-Xuan
DX
Zhou
Shu
S
D000328:Adult; D000368:Aged; D003646:Debridement; D004322:Drainage; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D055815:Young Adult