Percutaneous and transhepatic catheter drainage

Suitable for hepatic abscess. The lower lung boundary should be observed under fluoroscopy before surgery. Elderly emphysema and uncooperative patients should not be used. Treatment of diseases: liver abscess amoebic liver abscess Indication 1. A bacterial liver abscess with a large abscess. 2. Amoebic liver abscess secondary infection or non-surgical treatment is invalid. 3. Hepatic cysticercosis secondary infection. Contraindications 1. The blood coagulation mechanism has serious obstacles. 2. Severe acute suppurative obstructive cholangitis. 3. Liver and kidney function is very poor. 4. The patient is too old and should be filled with poor general condition. Preoperative preparation 1. Full support for treatment: a small amount, multiple blood transfusions, fluid replacement, correction of water and electricity balance disorders and hypoproteinemia. 2. Anti-infective treatment: According to the determination of bacterial sensitivity, the pathogenic strain is estimated, sensitive antibiotics are selected or combined with broad-spectrum antibiotics. 3. Positioning: In order to further confirm the diagnosis and determine the surgical approach, the abscess can be determined according to physical signs, ultrasound, X-ray or liver abscess test puncture. Generally, tenderness, edema of the lower chest wall, and tenderness of the intercostal space are often abscesses. Surgical procedure According to the results of B-ultrasound, combined with the right lower lung boundary, percutaneous transhepatic biliary drainage (PTCD) was used to perform liver abscess puncture. After the puncture point is selected, local anesthesia is used. The syringe is connected to the syringe with a trocar. The needle is pulled back while the needle is pulled. After the pus is drawn, the needle core is pulled out, the sleeve is kept in the abscess, and the drainage bag is drained. You can also use the Seldinge method of femoral artery angiography: puncture with a trocar that can be passed through the angiographic guide wire, pull out the needle core and introduce the angiographic guide wire, fix the wire, pull out the trocar, and then put the plastic drainage tube on the guide wire. Outside, insert the abscess cavity along the wire and secure it.