Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

Abstract

PurposeTo improve the selection of patients for percutaneous abscess drainage (PAD) to treat postoperative intra-abdominal abscess after gastrointestinal surgery, we investigated the factors predictive of outcome.MethodsOf 143 consecutive patients with symptomatic postoperative intra-abdominal abscess after a gastrointestinal tract resection, 104 who underwent image-guided PAD as the initial treatment were reviewed. We assessed the possible associations between successful PAD and patient-, abscess-, surgical-, and drainage-related variables, and investigated the success rates of PAD for patients with vs. those without the factors related to successful outcome.ResultsBased on monitoring for 1 year after PAD, the success rate of this procedure was 85.6 % (89/104). Multivariate analysis revealed that the interval between surgery and the onset of abscess (p = 0.0234) and a single abscess (p = 0.0038) were independently associated with a successful outcome. Single late-onset abscess resolved completely within 10 weeks in 91.4 % of these patients.ConclusionsDespite new strategies aimed at preventing surgical site infection, PAD remains an important factor in the postoperative management of gastrointestinal surgery in Japan. Initial recognition of the day of onset and the number of abscesses are important prognostic factors.

Image Guided Percutaneous Drainage of Intra-Abdominal Collections

“…Ultrasonogram was at par with CT scan for guidance of PCD, hence, it may be preferred being easily available, cheaper and without radiation exposure. PCD has a prime role in the treatment of post-operative collections with a success rate of 81%-85.6%, an observation echoed by our study where PCD had immense success [5][6][7]. PCD may be complicated by bleeding, hollow viscus perforation, migration etc.…”

“…The success rate of image guided PCD ranges widely from 70%-97% for single / late onset abscess and about 80% in cases of multiple/ early onset abscesses [5][6][7]. Large sized collections, multiple collections and CT guided aspirations have been found to result in higher success rate.…”

Impact of Surgical Infection Society/Infectious Disease Society of America-recommended antibiotics on postoperative intra-abdominal abscess with image-guided percutaneous abscess drainage following gastrointestinal surgery

“…Golfieri et al described that there is a general consensus among studies in the literature about PAD in conjunction with antibiotics as initial treatment for postoperative intra-abdominal abscesses [8]. In our previous study, we examined 104 patients with postoperative abscesses with and without anastomotic leakage who underwent image-guided PAD as the initial treatment [27]. A multivariable analysis showed that a shorter interval between surgery and onset and having multiple abscesses, but not the use of antibiotic therapy, were related to the failure of PAD.…”

Analysis of Early Complications After Using Permacol Bioimplant in Combination With Selective Administration of the Nicergolin in Case of Intestinal Fistulas

“…Некоторые ав-торы предлагают агрессивную терапию с хирур-гическими повторными вмешательствами, в то время как другие рекомендуют консервативное лечение антибиотиками широкого спектра дейс-твия, полным парентеральным питанием и на-ружно-внутренним чрескожным дренированием. По данным Ercoli et al на основании анализа 99 пациентов с абдоминальными и забрюшинными абсцессами, связанными с высокими кишечными свищами, продемонстрирована эффективность ведения пациентов на чрескожных дренажах [12]. При этом у двух (13%) пациентов было полное разрешение свищей, у 10 (67%) пациентов слу-чился рецидив абсцессов, у троих (20%) паци-ентов технически не получилось провести чрес-кожный дренаж и были проведены открытые операции.…”