Peripancreatic transfixing irrigation-drainage for postoperative residual infected pancreatic necrosis

doi:10.19538/j.cjps.issn1005-2208.2017.07.24

Abstract：Objective To develop an effective postoperative peripancreatic irrigation-drainage method for infected pancreatic necrosis(IPN)after operation. Methods The clinical data of 43 cases of acute pancreatitis(AP)received surgical treatment in the First Affiliated Hospital, Henan University of Science & Technology from January 2011 to December 2015 were analized retrospectivly. According to the postoperative peripancreatic drainage method,the cases were divided into groups A (n=22, peripancreatic transfixing irrigation-drainage,PTID) , and group B (n=21,continuous lavage of the lesser and retroperitoneum). For the patients in group A, PTID tubes were placed in operation. For the patients in group B, the lesser and retroperitoneum tubes were placed in operation. For the two groups, the incidence of severe complications, re-operation, death, and peripancreatic residual necrosis infections were observed and compared. Results For group A,all 22 cases recoveried including 4 severe complications. For group B, 17 cases recoveried and 4 died, including 13 severe complications. Except for the recovery rate(100%vs. 81.0%), the rates of severe complications (18.2%vs. 61.9%), death(0 vs. 19.0%), re-operation(0 vs. 66.7%), draining patency(100%vs. 60.7%), and days of hospital stay[(30.6±9.4)d vs.(70.5±30.7)d]of the two groups were all different statisticaly(P<0.05). The positive rate of post-operation peripancreatic fluide germiculture decreased both. At the 4th week after operation, there were 6 cases of peripancreatic residual infection in group A, and 18 cases in group B, with statistical difference(P<0.01). Conclusion PTID is an effective drainage method with high draining patency,which can be used to clean the residual infected necrosis after infected necrotizing pancreatitis operation.