Percutaneous drainage of postoperative abdominal abscess with limited accessibility: preexisting surgical drains as alternative access route.

PURPOSE

To retrospectively assess the effectiveness and safety of postoperative percutaneous drainage of abdominal abscesses with limited accessibility by using a preexisting surgical drain as an access route.

MATERIALS AND METHODS

The study was approved by the institutional review board, and informed consent was not required. The authors reviewed the medical records of 92 patients (62 male, 30 female; median age, 59 years; age range, 3-79 years) with postoperative abdominal abscesses in whom percutaneous drainage was performed by using surgical drains as an access. Factors evaluated included the location and size of the lesion; time between surgery and the drainage procedure; distance between the lesion and surgical drain; presence of fistula; duration of drainage; type of surgical drain; size, type, and length of drainage catheter; and complications. Technical success was defined as adequate placement of a new drainage catheter into the target abscess. Midterm success was defined as avoidance of surgery or additional percutaneous drainage during the 6 months of follow-up. Univariate analysis and multiple logistic regression analysis were performed to determine factors that affected the technical or midterm success of the procedure.

RESULTS

Of 92 postoperative abscesses for which the technique was attempted, 56 (61%) had a subphrenic location and 36 (39%) had a peripancreatic location. Technical success was achieved in 87 of the 92 patients (95%). Technical success was not significantly associated with any of the factors tested. Midterm success was achieved in 75 of the 87 patients (86%) in whom technical success was achieved. Midterm failure showed a statistically significant relationship with the presence of fistula (P = .04). No procedure-related complications were identified.

CONCLUSION

Percutaneous drainage by using the surgical drain as an access route is an effective and safe alternative for draining postoperative abdominal abscesses that are less accessible with direct puncture..