Service d'imagerie médicale, département de radiologie digestive, CHU Amiens Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France.
J Visc Surg. 2013 Jun;150(3 Suppl):S11-8. doi: 10.1016/j.jviscsurg.2013.05.005. Epub 2013 Jun 20.
Since the initial studies published in the eighties, percutaneous radiologic drainage, is considered the first-line treatment of infected post-operative collections and is successful in over 80% of patients. Mortality due to undrained abscesses is estimated between 45 and 100%. Radiology-guided percutaneous drainage can be performed either with curative intent or to improve patient status prior to re-operation under better conditions. Cross-sectional imaging, using either ultrasound or computed tomography (CT), has changed the management of post-operative complications. Percutaneous drainage is most often performed by interventional radiologists and imaging is essential for road-mapping and guiding the puncture and drainage of intra-abdominal collections. Indeed, such imaging allows both identification of adjacent anatomical structures and determination of the best tract and the safest route. Cooperation between the surgeon and the interventional radiologist is essential to optimize the management and to avoid, if possible, surgery, which is so often difficult in this setting.
自 80 年代最初的研究发表以来,经皮放射学引流被认为是治疗感染性术后积液的一线治疗方法,在超过 80%的患者中取得了成功。未引流脓肿的死亡率估计在 45%至 100%之间。放射学引导的经皮引流可以是治疗性的,也可以是在更好的条件下重新手术前改善患者状况。使用超声或计算机断层扫描 (CT) 的横断面成像改变了术后并发症的管理方式。经皮引流通常由介入放射科医生进行,影像学对于规划路径和引导腹腔内积液的穿刺和引流至关重要。事实上,这种影像学检查既能确定相邻的解剖结构,又能确定最佳的通道和最安全的路径。外科医生和介入放射科医生之间的合作对于优化管理非常重要,并尽可能避免在这种情况下经常难以进行的手术。