Clinical Study on CT Guided Puncture to The Diagnosis and Treatment of Local Complications of Severe Acute Pancreatitis (Report of 43 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAO Xinmin , YU Lan , ZHANG Shu , XIAO Yuqing , YANG Yicun , CAO Yang , HUANG Jiangtao , HUANG Dequan , LUO Jing , PENG Qiusheng

Department of Hepatobiliary Pancreatic Research Office of General Surgery, The 3rd Peoples Hospital of Chengdu City, Chengdu 610031, ChinaCorresponding Author： YAO Xin-min, E-mail： xinmin_yao@163.com;

Corresponding author：

Keywords：

Severe acute pancreatitis; CT guided; Puncture; Aspiration; Tube drainage

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Objective 　 To explore the value of CT guided percutaneous puncture, aspiration and drainage on diagnosis and treatment of local complications of severe acute pancreatitis (SAP).
Methods　Forty-three cases of SAP combined with pancreatic necrosis, peripancreatic hydrops, pseudocyst and abscess were analyzed, all of them underwent CT guided percutaneous puncture, aspiration and drainage.
Results 　The punctures were performed on 43 SAP patients for sixty-four times, the success rate was 100%, and in 24 cases of them puncture were performed for diagnosis, the positive rate of fluid absorption by puncture was 100%. Forty-one of 43 cases (95%) received puncture and tube drainage, open operation was performed in one patient, one patient was automatically discharged. The remission rate of abdominal distension was 93% (40/43) and 16 of 43 cases (37%) were turned to open operation. The effective rate of drainage was 61% (25/41).
Conclusion 　The puncture, aspiration and drainage guided by CT is an effective method in diagnosis and treatment of local complications in part of SAP cases.

Citation： YAO Xinmin ,YU Lan,ZHANG Shu,XIAO Yuqing,YANG Yicun,CAO Yang,HUANG Jiangtao,HUANG Dequan,LUO Jing,PENG Qiusheng. Clinical Study on CT Guided Puncture to The Diagnosis and Treatment of Local Complications of Severe Acute Pancreatitis (Report of 43 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(8): 560-563. doi: Copy

1.	张圣道，雷若庆. 指南后时代重症急性胰腺炎外科治疗的一些关键问题 [Ｊ]. 中国普外基础与临床杂志， 2007； 14(4)∶381.
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5.	Bradley EL 3rd, Allen K. A prospective longitudinal study of observation versus surgical intervention in the management of necrotizing pancreatitis [Ｊ]. Am J Surg, 1991; 161(1)∶19.
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12.	Elmas N. The role of diagnostic radiology in pancreatitis [Ｊ]. Eur J Radiol, 2001; 38(2)∶120.
13.	李维勤，黎介寿，赵允召. CT或B超引导下经皮穿刺置管引流在重症急性胰腺炎中的应用 [Ｊ]. 中国实用外科杂志， 2003； 23(9)∶520.
14.	Gouzi JL, Bloom E, Julio C, et al. Percutaneous drainage of infected pancreatic necrosis: an alternative to surgery[Ｊ]. Chirurgie, 1999; 124(1)∶31.
15.	Chen YF, Chiang HJ, Chang JH. Abdominal fluid collection secondary to acute pancreatitis: treated with percutaneous catheter drainage [Ｊ]. Zhonghua Yi Xue Za Zhi(Taipei), 1997; 60(5)∶265.
16.	Neme瘙塂 R, Georgescu I, Mrgritescu D, et al. The pancreatic pseudocyst—late complication of the severe acute pancreatitis. Therapeutic options [Ｊ]. Chirurgia (Bucur), 2006; 101(3)∶259.
17.	杨宁，胡立斌，潘杰，等. CT引导下胰腺假性囊肿外引流术的临床应用[Ｊ]. 中华放射学杂志, 2002; 36(10)∶904.
18.	张圣道，雷若庆. 重症急性胰腺炎诊治指南 [C]. 第十一届全国胰腺外科学术研讨会论文汇编， 2006∶27.
19.	李德宇. 重症急性胰腺炎手术指征及疗效分析 [Ｊ]. 中国普外基础与临床杂志， 2005； 12(5)∶499.
20.	van Sonnenberg E, Wittich GR, Chon KS, et al. Percutaneous radiologic drainage of pancreatic abscesses [Ｊ]. AJR Am J Roentgenol, 1997; 168(4)∶979.

1. 　张圣道，雷若庆. 指南后时代重症急性胰腺炎外科治疗的一些关键问题 [Ｊ]. 中国普外基础与临床杂志， 2007； 14(4)∶381.
2. 　余文，吴伟，张少辉，等. 急性胰腺炎发病机理的研究进展 [Ｊ]. 中国普外基础与临床杂志， 2006； 13(6)∶733.
3. 　Beger HG, Rau B, Isenmann R. Natural history of necrotizing pancreatitis [Ｊ]. Pancreatology, 2003; 3(2)∶93.
4. 　Beger HG, Bittner R, Block S, et al. Bacterial contamination of pancreatic necrosis. A prospective clinical study[Ｊ]. Gastroenterology, 1986; 91(2)∶433.
5. 　Bradley EL 3rd, Allen K. A prospective longitudinal study of observation versus surgical intervention in the management of necrotizing pancreatitis [Ｊ]. Am J Surg, 1991; 161(1)∶19.
6. 　Büchler MW, Gloor B, Müller CA, et al. Acute necrotizing pancreatitis: treatment strategy according to the status of infection [Ｊ]. Ann Surg, 2000; 232(5)∶619.
7. 　Heath D, Alexander D, Wilson C, et al. Which complications of acute pancreatitis are most lethal? A prospective multicenter study of 719 episodes [Ｊ]. Gut, 1995; 36(3)∶A478.
8. 　李非，孙家邦. CT引导细针穿刺诊断胰腺感染的入路选择[Ｊ]. 中国实用外科杂志, 1999; 19(9)∶542.
9. 　Dervenis C, Johnson CD, Bassi C, et al. Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference [Ｊ]. Int J Pancreatol, 1999; 25(3)∶195.
10. 　King NK, Siriwardena AK. European survey of surgical strategies for the management of severe acute pancreatitis [Ｊ]. Am J Gastroenterol, 2004; 99(4)∶719.
11. 　Sandberg AA, Borgstrm A. Early prediction of severity in acute pancreatitis. Is this possible? [Ｊ]. JOP, 2002; 3(5)∶116.
12. 　Elmas N. The role of diagnostic radiology in pancreatitis [Ｊ]. Eur J Radiol, 2001; 38(2)∶120.
13. 　李维勤，黎介寿，赵允召. CT或B超引导下经皮穿刺置管引流在重症急性胰腺炎中的应用 [Ｊ]. 中国实用外科杂志， 2003； 23(9)∶520.
14. 　Gouzi JL, Bloom E, Julio C, et al. Percutaneous drainage of infected pancreatic necrosis: an alternative to surgery[Ｊ]. Chirurgie, 1999; 124(1)∶31.
15. 　Chen YF, Chiang HJ, Chang JH. Abdominal fluid collection secondary to acute pancreatitis: treated with percutaneous catheter drainage [Ｊ]. Zhonghua Yi Xue Za Zhi(Taipei), 1997; 60(5)∶265.
16. 　Neme瘙塂 R, Georgescu I, Mrgritescu D, et al. The pancreatic pseudocyst—late complication of the severe acute pancreatitis. Therapeutic options [Ｊ]. Chirurgia (Bucur), 2006; 101(3)∶259.
17. 　杨宁，胡立斌，潘杰，等. CT引导下胰腺假性囊肿外引流术的临床应用[Ｊ]. 中华放射学杂志, 2002; 36(10)∶904.
18. 　张圣道，雷若庆. 重症急性胰腺炎诊治指南 [C]. 第十一届全国胰腺外科学术研讨会论文汇编， 2006∶27.
19. 　李德宇. 重症急性胰腺炎手术指征及疗效分析 [Ｊ]. 中国普外基础与临床杂志， 2005； 12(5)∶499.
20. 　van Sonnenberg E, Wittich GR, Chon KS, et al. Percutaneous radiologic drainage of pancreatic abscesses [Ｊ]. AJR Am J Roentgenol, 1997; 168(4)∶979.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Study on CT Guided Puncture to The Diagnosis and Treatment of Local Complications of Severe Acute Pancreatitis (Report of 43 Cases)

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