Department of Hepato-Pancreatico-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Br J Radiol. 2010 Sep;83(993):e195-7. doi: 10.1259/bjr/69471744.
The objective of this case report is to describe a device that can be used as a minimally invasive alternative for the treatment of drainage-resistant liver abscess. The device uses pulse lavage to fragment and evacuate the semi-solid contents of a liver abscess. The treatment of liver abscesses consists of percutaneous drainage, antibiotics and treatment of the underlying cause. This approach can be ineffective if the contents of the abscess cavity are not liquid, and in those cases open surgery is often needed. Here, we describe for the first time a new minimally invasive technique for treating persistent liver abscesses. A patient developed a liver abscess after a hepatico-jejunostomy performed as a palliative treatment for an unresectable pancreatic head carcinoma. Simple drainage by a percutaneously placed pig-tail catheter was insufficient because of inadequate removal of the contents of the abscess cavity. After dilatation of the drain tract the persistent semi-solid necrotic contents were fragmented by a pulsed lavage device, after which the abscess healed uneventfully. The application of pulsed lavage for debridement of drainage-resistant liver abscesses proved to be an effective and minimally invasive alternative to open surgery.
本病例报告的目的是描述一种可用于治疗引流抵抗性肝脓肿的微创替代方法的设备。该设备使用脉冲冲洗来使肝脓肿的半固体内容物碎裂并排出。肝脓肿的治疗包括经皮引流、抗生素治疗和基础病因治疗。如果脓肿腔内容物不是液体，这种方法可能无效，此时通常需要进行开放性手术。在这里，我们首次描述了一种治疗持续性肝脓肿的新微创技术。一位患者在因无法切除的胰头癌而行姑息性胆肠吻合术后发生肝脓肿。由于未能充分清除脓肿腔内容物，经皮放置的猪尾导管单纯引流效果不佳。在扩张引流管后，使用脉冲冲洗装置将持续存在的半固体坏死物碎裂，之后脓肿顺利愈合。脉冲冲洗在清创引流抵抗性肝脓肿方面的应用被证明是一种有效且微创的开放性手术替代方法。
