Purpose

To investigate the feasibility and safety of a modified surgical drain–guided percutaneous catheter drainage technique for postoperative fluid collection in inaccessible locations.

Materials and Methods

The modified technique was used in 24 patients (age, 58.6 years ± 11.3; men, 58.3%) from September 2015 to March 2021. All fluid collections had no safe access route on preprocedural computed tomography (CT) images. Every patient had a long (>20 cm) and tortuous surgical drain, which prevented the use of conventional surgical drain exchange. A favorable midpoint of the surgical drain tract was punctured under either ultrasound or fluoroscopic guidance, and a guide wire was advanced into the fluid collection. Technical success was defined as the successful placement of a drainage catheter, and clinical success was defined as the complete evacuation of fluid collection without recurrence. Follow-up was performed using CT images and a chart review. Adverse events within 30 days of the procedure were evaluated.

Results

Target fluid collections in the pelvic cavity (n = 9); subphrenic (n = 7), peripancreatic (n = 4), and subhepatic spaces (n = 3); and abdominal cavity (n = 1) were drained using catheters measuring 7–10.2 F in diameter and 25–30 cm in length. The technical success rate was 91.7% (22/24), and the clinical success rate was 90.9% (20/22). No procedure-related or catheter-related adverse events were observed. The median follow-up period was 8.2 months (range, 10–1,721 days).

Conclusions

The modified surgical drain–guided percutaneous catheter drainage technique is a useful alternative when conventional exchange techniques cannot be used because of long and tortuous surgical drain paths.

中文翻译：

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改良手术引流引导经皮导管引流难以进入部位的术后积液

目的

旨在研究改进的手术引流引导经皮导管引流技术在难以接近的位置收集术后液体的可行性和安全性。

材料和方法

从 2015 年 9 月到 2021 年 3 月，24 名患者（年龄，58.6 ± 11.3；男性，58.3%）使用了改进的技术。所有液体收集在术前计算机断层扫描 (CT) 图像上都没有安全的通路。每个患者都有一个长（> 20 厘米）和曲折的手术引流管，这妨碍了使用传统的手术引流管交换。在超声或透视引导下刺穿手术引流管的有利中点，并将导丝推进到积液中。技术成功定义为成功放置引流管，临床成功定义为积液完全排出无复发。使用 CT 图像和图表回顾进行随访。评估了手术后 30 天内的不良事件。

结果

盆腔中的目标液体收集（n = 9）；膈下 (n = 7)、胰周 (n = 4) 和肝下间隙 (n = 3)；使用直径为 7-10.2 F、长度为 25-30 cm 的导管对腹腔 (n = 1) 进行引流。技术成功率为91.7%（22/24），临床成功率为90.9%（20/22）。没有观察到与手术相关或导管相关的不良事件。中位随访期为 8.2 个月（范围，10-1,721 天）。

结论

当由于长而曲折的手术引流路径而无法使用传统交换技术时，改良的手术引流引导经皮导管引流技术是一种有用的替代方法。