Trumm Christoph G, Hackner Danilo, Badmann Katharina, Crispin Alexander, Forbrig Robert, Ozpeynirci Yigit, Kuppinger David, Pedersen Vera, Liebig Thomas, Stahl Robert
Institute for Diagnostic and Interventional Neuroradiology, University Hospital, Ludwig-Maximilians-University (LMU), Marchioninistr. 15, 81377 Munich, Germany.
Department of General and Visceral Surgery, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nuremberg, Krankenhausstr. 12, 91054 Erlangen, Germany.
Diagnostics (Basel). 2022 Sep 16;12(9):2243. doi: 10.3390/diagnostics12092243.
(1) Purpose: To retrospectively assess the technical and clinical outcome of patients with symptomatic postoperative fluid collections after pancreatic surgery, treated with CT-guided drainage (CTD). (2) Methods: 133 eligible patients between 2004 and 2017 were included. We defined technical success as the sufficient drainage of the fluid collection(s) and the absence of peri-interventional complications (minor or major according to SIR criteria). Per definition, clinical success was characterized by normalization of specific blood parameters within 30 days after the intervention or a decrease by at least 50% without requiring additional surgical revision. C-reactive protein (CRP), Leukocytes, Interleukin-6, and Dose length product (DLP) for parts of the intervention were determined. (3) Results: 97.0% of 167 interventions were technically successful. Clinical success was achieved in 87.5% of CRP, in 78.4% of Leukocytes, and in 87.5% of Interleukin-6 assessments. The median of successful decrease was 6 days for CRP, 5 days for Leukocytes, and 2 days for Interleukin-6. No surgical revision was necessary in 93.2%. DLP was significantly lower in the second half of the observation period (total DLP: median 621.5 mGycm between 2011-2017 vs. median 944.5 mGycm between 2004-2010). (4) Conclusions: Technical success rate of CTD was very high and the clinical success rate was fair to good. Given an elderly and multimorbid patient cohort, CTD can have a temporizing effect in the postoperative period after pancreatic surgery. Reducing the radiation dose over time might reflect developments in CT technology and increased experience of interventional radiologists.
（1）目的：回顾性评估接受CT引导下引流（CTD）治疗的胰腺手术后出现有症状的术后积液患者的技术及临床疗效。（2）方法：纳入2004年至2017年间133例符合条件的患者。我们将技术成功定义为积液充分引流且无介入治疗期间并发症（根据SIR标准分为轻微或严重）。根据定义，临床成功的特征是干预后30天内特定血液参数恢复正常，或至少降低50%且无需额外手术修正。测定了干预部分的C反应蛋白（CRP）、白细胞、白细胞介素-6和剂量长度乘积（DLP）。（3）结果：167次干预中有97.0%技术成功。CRP评估中有87.5%取得临床成功，白细胞评估中有78.4%取得临床成功，白细胞介素-6评估中有87.5%取得临床成功。CRP成功下降的中位数为6天，白细胞为5天，白细胞介素-6为2天。93.2%的患者无需手术修正。观察期后半段的DLP显著更低（总DLP：2011 - 2017年中位数为621.5 mGycm，2004 - 2010年中位数为944.5 mGycm）。（4）结论：CTD的技术成功率非常高，临床成功率良好。鉴于患者群体为老年人且患有多种疾病，CTD在胰腺手术后的术后阶段可起到暂时缓解作用。随着时间推移辐射剂量降低可能反映了CT技术的发展以及介入放射科医生经验的增加。
