Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 28, 2010; 16(4): 513-517
Published online Jan 28, 2010. doi: 10.3748/wjg.v16.i4.513
Percutaneous catheter drainage in combination with choledochoscope-guided debridement in treatment of peripancreatic infection
Li-Jun Tang, Tao Wang, Jian-Feng Cui, Bing-Yin Zhang, Shi Li, Dong-Xuan Li, Shu Zhou
Li-Jun Tang, Tao Wang, Jian-Feng Cui, Bing-Yin Zhang, Shi Li, Dong-Xuan Li, Shu Zhou, Center of General Surgery, Chengdu General Hospital of Chengdu Military Area Command, Chengdu 610083, Sichuan Province, China
Author contributions: Tang LJ, Wang T and Cui JF performed the majority of operation and wrote the manuscript; Zhang BY, Li S and Li DX provided the operative tools and observed the patients after operation; Zhou S collected the data of patients.
Correspondence to: Li-Jun Tang, MD, Center of General Surgery, Chengdu General Hospital of Chengdu Military Area Command, Chengdu 610083, Sichuan Province, China. whjtlj@yahoo.com.cn
Telephone: +86-28-86570524 Fax: +86-28-86570620
Received: November 11, 2009
Revised: December 9, 2009
Accepted: December 16, 2009
Published online: January 28, 2010
Abstract

AIM: 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.

CONCLUSION: Percutaneous catheter drainage in combination with choledochoscope-guided debridement is a simple, safe and reliable treatment procedure for peripancreatic infections secondary to SAP.

Keywords: Severe acute pancreatitis, Peripancreatic infection, Percutaneous catheter drainage, Choledochoscope, Debridement