Flament J B, Delattre J F, Palot J P, Avisse C, Burde A
Service de Chirurgie générale et digestive, C.H.U., hôpital Robert-Debré, Reims.
Chirurgie. 1991;117(4):298-310; discussion 310-1.
Percutaneous drainage has become, during the last ten years, the treatment of choice of abdominal abscesses. From January 1986 to January 1990, 205 patients have been treated in our department for an abdominal collection. In this prospective work we have realised percutaneous drainage in every patients who would have been operated, according to the classical indications. In 28 patients (acute cholecystitis), the indication has been elective because of the surgical risk, depending to the age (mean 80 years). We have treated 67 intra abdominal collections (34 post operative), 39 pseudocysts of the pancreas, 40 liver collections (18 abscesses); and we have done 37 biliary drainages. 15% of the patients showed communication of the collection with the digestive tract. Mortality was less than 5%. Half of these deaths occurred during the evolution of necrotic pancreatitis. 78% of the patients have been cured by the percutaneous drain. The other patients have been operated upon but the drainage facilitated the operation. In our experience percutaneous drainage is a secure technique and every abdominal surgeon would be able to practice this technique.
在过去十年中,经皮引流已成为腹部脓肿的首选治疗方法。1986年1月至1990年1月,我科共治疗了205例腹部积液患者。在这项前瞻性研究中,我们根据经典指征,对每例原本需要手术治疗的患者都实施了经皮引流。在28例患者(急性胆囊炎)中,由于手术风险(取决于年龄,平均80岁),引流指征为选择性的。我们治疗了67例腹腔积液(34例为术后积液)、39例胰腺假性囊肿、40例肝脏积液(18例为脓肿);并进行了37例胆道引流。15%的患者显示积液与消化道相通。死亡率低于5%。这些死亡病例中有一半发生在坏死性胰腺炎的病程中。78%的患者通过经皮引流治愈。其他患者接受了手术,但引流使手术变得更容易。根据我们的经验,经皮引流是一种安全的技术,每位腹部外科医生都能够实施这项技术。