| 급성췌장염에 의한 감염성 합병증의 내시경적 |
| 김정한·박종재·유상균·정영걸·이지연·윤 익·김경오·임형준·김진용·연종은·김재선·변관수·박영태·이창홍 |
| 고려대학교 의과대학 내과학교실 |
| Definitive Treatment of Infected Pancreatic Fluid Collection by Endoscopic Transmural Drainage |
| Jeong Han Kim, M.D., Jong-Jae Park, M.D., Sang Kyun Yu, M.D., Young Kul Jung, M.D., Ji Yeon Lee, M.D., Ik Yoon, M.D., Kyung Oh Kim, M.D., Hyung Joon Yim, M.D., Jin Yong Kim, M.D, Jong Eun Yeon, M.D., Jae Seon Kim, M.D., Kwan Soo Byun, M.D., Young-Tae Bak, |
| Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
Recent experience with endoscopic transmural drainage of pancreatic pseudocysts prompted the use of a similar technique for the primary treatment of infected pancreatic fluid collection (PFC) such as pancreatic abscess and infected pancreatic necrosis (IPN). The aim of this study was to determine the safety and effectiveness of endoscopic transmural drainage for the primary treatment of infected PFC complicating acute pancreatitis.
Methods:
In 11 patients, a total of 13 infected PFC (11 pancreatic abscesses and 2 IPNs) compressing the stomach, duodenum, or both were drained endoscopically by means of an endoscopic fistulization followed by stent (s) placement alone or additional nasopancreatic catheter insertion. Complete resolution of PFC was defined as the absence of symptoms and no residual collection on the follow-up computed tomography.
Results:
Complete resolution was achieved in 12 infected PFC (92%) (10 pancreatic abscesses and 2 IPNs) after stent placement for a mean duration of 31 days. For IPN and 2 pancreatic abscess, insertion of a nasopancreatic catheter was required to irrigate thick pus or necrotic debris. There was 1 case of bleeding (8%) but no mortality.
Conclusions:
Endoscopic transmural drainage is an effective therapy with minimal morbidity for infected pancreatic fluid collection compressing the gut lumen and is a valuable alternative to surgical drainage. (Korean J Gastrointest Endosc 2004;28:917) |
| Key Words:
Endoscopic transmural drainage, Pancreatic abscess, Infected pancreatic necrosis, Acute pancreatitis |
| 주요어:
내시경적 내부배액술, 췌장농양, 감염성 췌장괴사, 급성췌장염 |
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