• Title/Summary/Keyword: Internal drainage

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Comparison of Infection between Internal-External and External Percutaneous Transhepatic Biliary Drainage in Treating Patients with Malignant Obstructive Jaundice

  • Xu, Chuan;Huang, Xin-En;Wang, Shu-Xiang;Lv, Peng-Hua;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2543-2546
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    • 2015
  • Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

Internal-External Percutaneous Transhepatic Biliary Drainage for Patients with Malignant Obstructive Jaundice

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Sun, Ling;Wang, Shu-Xiang;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9391-9394
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    • 2014
  • Purpose: To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice. Methods: During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD. Results: Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05). Conclusions: The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.

The Treatment of Massive Spontaneous Subcutaneous Emphysema by Multiple Intravenous Catheter and Continuous Suction Drainage (다수의 정맥용 도관의 피하삽입과 지속흡인을 이용한 다량의 자발성 피하공기증 치료 1예)

  • Kim, Sun Young;Uom, Kwang Seok;Lee, Young Seok;Huh, Kyung Rim;Kwon, Chin Woo;Jang, Seung Hun;Kim, Dong Gyu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.178-183
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    • 2006
  • A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient's dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction.

Autoimmune Pancreatitis Featuring a Pseudocyst Requiring Drainage despite Steroid Therapy (스테로이드 치료에도 불구하고 낭종 배액술이 필요하였던 가성낭종을 동반한 자가면역 췌장염)

  • Park, Jae Cheol;Im, Hyeon-Su;Kang, Yewon;Son, Hyo-Ju;Jung, Kyung Hwa;Han, Jisoo;Kim, Myung-Hwan
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.560-564
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    • 2018
  • Autoimmune pancreatitis (AIP) is rarely associated with pancreatic pseudocysts. AIP-associated pseudocysts requiring drainage despite steroid therapy are rather rare. We report a case of AIP with an infected pseudocyst requiring drainage despite steroid therapy. A 68-year-old male was diagnosed with AIP via pancreatic imaging, a high serum immunoglobulin G4 level, and steroid responsiveness. The AIP was accompanied by a pancreatic pseudocyst. Steroid therapy was prescribed, but the pancreatic pseudocyst became aggravated during steroid tapering. Endoscopic ultrasonography-guided cyst drainage was required; the pseudocyst then became completely resolved.

Role of interventional endoscopic ultrasound in a developing country

  • Hasan Maulahela;Nagita Gianty Annisa;Achmad Fauzi;Kaka Renaldi;Murdani Abdullah;Marcellus Simadibrata;Dadang Makmun;Ari Fahrial Syam
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.100-106
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    • 2023
  • Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young;Lee, Jae Sin;Kim, Dong Ryul;Jang, Jae Young;Jung, Hwa Young;Park, Jong Ho;Jin, Sue Sin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.109-113
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    • 2018
  • A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Cerebral Air Embolism Following Pigtail Catheter Insertion for Pleural Fluid Drainage

  • Kim, Sa Il;Kwak, Hyun Jung;Moon, Ji-Yong;Kim, Sang-Heon;Kim, Tae Hyung;Sohn, Jang Won;Shin, Dong Ho;Park, Sung Soo;Yoon, Ho Joo
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.286-290
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    • 2013
  • Pigtail catheter drainage is a common procedure for the treatment of pleural effusion and pneumothorax. The most common complications of pigtail catheter insertion are pneumothorax, hemorrhage and chest pains. Cerebral air embolism is rare, but often fatal. In this paper, we report a case of cerebral air embolism in association with the insertion of a pigtail catheter for the drainage of a pleural effusion. A 67-year-old man is being presented with dyspnea, cough and right-side chest pains and was administered antibiotics for the treatment of pneumonia. The pneumonia failed to resolve and a loculated parapneumonic pleural effusion developed. A pigtail catheter was inserted in order to drain the pleural effusion, which resulted in cerebral air embolism. The patient was administered high-flow oxygen therapy and recovered without any neurologic complications.

Endoscopic Intraluminal Drainage: An Alternative Treatment for Phlegmonous Esophagitis

  • Kim, Jong Won;Ahn, Hyo Yeong;Kim, Gwang Ha;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.165-169
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    • 2019
  • Phlegmonous esophagitis must be treated aggressively; therefore, appropriate antibiotic therapy and drainage are critical. Although a conventional surgical approach has been used previously, internal drainage could be another treatment option in light of advances in endoscopic techniques. We report 2 cases in which patients suffering from phlegmonous esophagitis were successfully treated with endoscopic intraluminal drainage and antibiotics.

Perforated Afferent Loop Syndrome in a Patient with Recurrent Gastric Cancer: Non-Surgical Treatment with Percutaneous Transhepatic Duodenal Drainage and Endoscopic Stent (재발된 위암 환자에서 발생한 천공성 수입각 증후군의 비수술적 치료)

  • Song Kyo Young;Son Chang Hee;Park Cho Hyun;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.176-179
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    • 2004
  • Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

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A Study on Urban Inundation Prediction Using Urban Runoff Model and Flood Inundation Model (도시유출모형과 홍수범람모형을 연계한 내수침수 적용성 평가)

  • Tak, Yong Hun;Kim, Jae Dong;Kim, Young Do;Kang, Boosik
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.36 no.3
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    • pp.395-406
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    • 2016
  • Population and development are concentrated by urbanization. Consequently, the usage of underground area and the riverside area have been increased. By increasing impermeable layer, the urban basin drainage is depending on level of sewer. Flood damage is occurred by shortage of sewer capacity and poor interior drainage at river stage. Many of researches about flood stress the unavailability of connection at the river stage with the internal inundation organically. In this study, flood calculated considering rainfall and combined inland-river. Also, using urban runoff model analyze the overflow of sewer. By using results of SWMM model, using flood inundation analysis model analyzed internal drainage efficiency of drainage system. Applying SWMM model, which results to flood inundation analysis model, analyzes internal drainage efficiency of drainage system under localized heavy rain in a basin of the city. The results of SWMM model show the smoothness of internal drainage can be impossible to achieve because of the influence of the river level and sewer overflow appearing. The main manholes were selected as the manhole of a lot of overflow volume. Overflow reduction scenarios were selected for expansion of sewer conduit and instruction retention pond. Overflow volume reduces to 45% and 33~64% by retention pond instruction and sewer conduit expansion. In addition, the results of simulating of flood inundation analysis model show the flood occurrence by road runoff moving along the road slope. Flooded area reduces to 19.6%, 60.5% in sewer conduit expansion scenarios.