Surgical treatment of acute pancreatitis: possibilities of percutaneous therapy

Топузов, Э Э; Балашов, В К; Tsatinyan, B G; Аршба, Э. А.; Petryashеv, A V; Bobrakov, M A

doi:10.17116/hirurgia2017891-94

“…Thirdly, debridement and other surgical procedures may cause mechanical damage to the intestine and increase the risk of intestinal fistula occurred [5]. Furthermore, the improper placement of drainage tube and long-term catheter drainage will oppress the intestinal tract and cause intestinal damage [6]. These are the main risk factors of the formation of intestinal fistula in severe acute pancreatitis (SAP) patients.…”

Section: Discussionmentioning

confidence: 99%

Colonic Fistula Secondary to Acute Pancreatitis: A Case Report

Jiang¹

2019

GMR

0

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Colonic fistula is rare after acute pancreatitis but is associated with a high mortality. In the current study, we describe a case of colonic fistula in a 39-year-old woman secondary to severe acute pancreatitis. Abdominal CT showed the presence of pancreatic pseudocysts. After percutaneous drainage was performance, yellow feculent liquid fluided from the drainage tubes. Subsequently, fistulography via drainage tube showed the presence of a colonic fistula into the descending colon. She was successfully treated by a colectomy for colonic fistula and drainage of the pancreatic pseudocysts. Although Colonic fistula is an infrequent complication of pancreatitis, clinicians should be aware of it because of its high mortality.

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“…Ïåðåâàãè ì³í³³íâàçèâíèõ ìåòîäèê íàä ëàïàðîòîìíèìè º âñòàíîâëåíèì ôàêòîì, ùî ï³äòâåðäaeåíî ÷èñëåííèìè äîñë³äaeåííÿì [5,8,9]. Òîìó â íàøîìó äîñë³äaeåíí³, ïðè îö³íö³ åôåêòèâíîñò³ ì³í³³íâàçèâíèõ ìåòîäèê, âðàõîâóâàëè ðåçóëüòàòèâí³ñòü îïå-ðàö³¿, òîáòî ö³ëüîâèé åôåêò, çàðàäè ÿêîãî âèêîíóâàëîñü âòðó÷àííÿ, òà ê³ëüê³ñòü óñêëàäíåíü.…”

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Punctional Drainages Under Ultrasound Control in Abdominal Surgery

Sydorenko

¹

2018

Med. Sci. of Ukr.

0

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Relevance. Punctic-drainage interventions under the control of ultrasound have become an effective help in complex treatment. But some technological aspects in the procedure and post-operative management of patients remain the subject of discussion. Objective: to improve the results of the use of punctional drainages under ultrasound control in abdominal and retroperitoneal pathology. Materials and methods. Echo-controlled puncture-drainage interventions are used in 89 patients: with pancreatogenic fluid concentrations in the stuffing box, parapancreatic cellular spaces (34); with intra-abdominal complications following operations on the abdominal organs (18), inflammatory processes in the gall bladder (15), tumor obstruction of the bile ducts (12), and with liver abscesses (10). Depending on the nature of the contents of the "target", its localization for puncture drainage was used by trokars of various modifications and diameters, as well as stylet-catheters of the type "PIGTAIL". Manipulation was carried out using ultrasonic devices with convection (frequency 3.5 MHz) and linear (frequency 7-12 MHz) sensors. In 68 patients, the display for intervention was infected fluid formation. In 12 – jaundice syndrome and 9 patients – sterile clusters of enzymatically active content. The main task of puncture-drainage procedures was the evacuation of the content of pathological or anatomical fluid formations to reduce intoxication and (or) their decompression. In assessing the effectiveness of minimally invasive techniques, account was taken of the effectiveness of the operation, that is, the target effect for which the intervention was performed, and the number of complications. Results. Puncture-drainage interventions have become independent and end-of-term treatment in 68 out of 85 cases (with the exception of 4 patients who, due to complications during the procedure, used other methods). The reasons for the reduced effectiveness of echo-controlled puncture-drainage interventions in 9 patients were: the predominance of the tissue component (large sequester) in the cavity, the presence of multiple isolated gates, the use of drainage structures with insufficient drainage properties. Fatal consequences in 5 patients are caused both by the above reasons, and by endogenous factors (a significant prevalence of the pathological process, decompensated background pathology, reduction of internal reserves of the organism). Conclusions. Puncture-draining interventions under ultrasound control are an alternative to open surgical interventions, especially in patients with severe concomitant pathology, severe general condition. In this case, they can be as element (stage) of complex treatment and an independent, final method of surgical care. The choice of echo-controlled interventional technologies as a method of operational correction should be carried out with understanding their capabilities. The effectiveness of such mini-invasive methods allows us to recommend their acceptance in surgical hospitals for diseases of the abdominal cavity organs and retroperitoneal space.

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Punctional Drainages Under Ultrasound Control in Abdominal Surgery

Sydorenko¹

2018

Med. Sci. of Ukr.

0

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Relevance. Punctic-drainage interventions under the control of ultrasound have become an effective help in complex treatment. But some technological aspects in the procedure and post-operative management of patients remain the subject of discussion. Objective: to improve the results of the use of punctional drainages under ultrasound control in abdominal and retroperitoneal pathology. Materials and methods. Echo-controlled puncture-drainage interventions are used in 89 patients: with pancreatogenic fluid concentrations in the stuffing box, parapancreatic cellular spaces (34); with intra-abdominal complications following operations on the abdominal organs (18), inflammatory processes in the gall bladder (15), tumor obstruction of the bile ducts (12), and with liver abscesses (10). Depending on the nature of the contents of the "target", its localization for puncture drainage was used by trokars of various modifications and diameters, as well as stylet-catheters of the type "PIGTAIL". Manipulation was carried out using ultrasonic devices with convection (frequency 3.5 MHz) and linear (frequency 7-12 MHz) sensors. In 68 patients, the display for intervention was infected fluid formation. In 12 – jaundice syndrome and 9 patients – sterile clusters of enzymatically active content. The main task of puncture-drainage procedures was the evacuation of the content of pathological or anatomical fluid formations to reduce intoxication and (or) their decompression. In assessing the effectiveness of minimally invasive techniques, account was taken of the effectiveness of the operation, that is, the target effect for which the intervention was performed, and the number of complications. Results. Puncture-drainage interventions have become independent and end-of-term treatment in 68 out of 85 cases (with the exception of 4 patients who, due to complications during the procedure, used other methods). The reasons for the reduced effectiveness of echo-controlled puncture-drainage interventions in 9 patients were: the predominance of the tissue component (large sequester) in the cavity, the presence of multiple isolated gates, the use of drainage structures with insufficient drainage properties. Fatal consequences in 5 patients are caused both by the above reasons, and by endogenous factors (a significant prevalence of the pathological process, decompensated background pathology, reduction of internal reserves of the organism). Conclusions. Puncture-draining interventions under ultrasound control are an alternative to open surgical interventions, especially in patients with severe concomitant pathology, severe general condition. In this case, they can be as element (stage) of complex treatment and an independent, final method of surgical care. The choice of echo-controlled interventional technologies as a method of operational correction should be carried out with understanding their capabilities. The effectiveness of such mini-invasive methods allows us to recommend their acceptance in surgical hospitals for diseases of the abdominal cavity organs and retroperitoneal space.

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Surgical treatment of acute pancreatitis: possibilities of percutaneous therapy

Cited by 4 publications

References 4 publications

Colonic Fistula Secondary to Acute Pancreatitis: A Case Report

Colonic Fistula Secondary to Acute Pancreatitis: A Case Report

Punctional Drainages Under Ultrasound Control in Abdominal Surgery

Punctional Drainages Under Ultrasound Control in Abdominal Surgery

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