介入超声联合胆道镜微创化治疗胰周脓肿
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鲁亚玲 E-mail:luyaling1983@163.com

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Minimally invasive therapy for peripancreatic abscess by combined use of interventional ultrasound and choledochoscopy
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    摘要:

    目的:探讨介入超声联合胆道镜建立治疗胰周脓肿微创化的模式。
    方法:对52例确诊胰周脓肿患者实施介入超声穿刺置管引流,而后扩张窦道,胆道镜清创患者的临床资料进行回顾性分析。
    结果:全组52例患者,50例经此方法治愈,治愈率96.2%,2例因穿刺引流效果欠佳改行开腹手术引流。50例患者平均治愈时间73 d,其中1例并发肠外瘘,2例并发出血,均经非手术治愈。所有患者随访3个月至1年以上,无胰周坏死组织残留。
    结论:介入超声联合胆道镜治疗胰周脓肿是一种安全、有效的治疗方法,可予推广应用。

    Abstract:

    Objective:To investigate a minimally invasive therapeutic procedure for peripancreatic abscess with the combined use of interventional ultrasound and choledochoscopy.
    Methods:The clinical data of 52 patients diagnosed as peripancreatic abscess, who underwent B-ultrasound guided percutaneous puncture and catheterized drainage, and subsequent irrigation and debridement by choledochoscopy after dilatation of the drainage catheter sinus tract, were retrospectively analzyed.
    Results:Of the 52 patients, 50 cases were cured by this procedure,  the curative rate was 96.2%, and the other 2 cases were converted to open drainage due to the inadequate catheter drainage. The average time for cure of the 50 cases was 73 days, of whom 1 case developed an enterocutaneous fistula and 2 cases were complicated by abdominal hemorrhage, but all the 3 cases were all cured by nonsurgical treatment. No residual peripancreatic necrosis was noted in any patient at the follow-up period of 3 months to >1 year.
    Conclusions:The combined use of interventional ultrasound and choledochoscopy is a safe and effective procedure for treatment of peripancreatic abscess, so it can be widely used.

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鲁亚玲| 汪涛| 汤礼军| 陈琪| 张辉.介入超声联合胆道镜微创化治疗胰周脓肿[J].中国普通外科杂志,2011,20(9):921-924.
DOI:10.7659/j. issn.1005-6947.2011.09.005

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  • 收稿日期:2011-06-28
  • 最后修改日期:2011-09-01
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  • 在线发布日期: 2011-09-15