介入超声联合胆道镜微创化治疗胰周脓肿

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

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。

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.