İntrahepatik safra yolları ile ilişkisi gösterilen piyojenik karaciğer abselerinin endoskopi nazo-biliyer kateter ile drenajı
Piyojenik karaciğer abseleri sıklıkla biliyer sistem patolojileri sonucu gelişmekte olup, hastadan hastaya değişmekle birlikte tedavide en sık antibiyotik tedavisi ve perkütan drenaj uygulanmaktadır. Bunlara ilave olarak ancak cerrahi girişim ile tedavi edilebilen durumlar da söz konusudur. Son dönemde özellikle biliyer sistem patolojileri sonucu gelişen abselerin sfinkterotomi, darlık dilatasyonları, stent yerleştirilmesi ve daha da nadir olarak abse poşuna nazobiliyer dren yerleştirilmesi ile endoskopik tedavileri gündeme gelmiştir. Burada asendan kolanjit sonucu pyojenik abse gelişen 3 olgunun abse poşuna nazobiliyer dren yerleştirilmesi ve sonrası seyirleri ile ilgili verileri sunmayı amaçladık.
Endoscopic nasobiliary drainage of a pyogenic liver abscess that communicates with intrahepatic bile ducts
Pyogenic liver abscess generally occurs secondary to biliary system pathologies, and first-line treatment consists of antibiotherapy together with percutaneous drainage, although it can vary patient to patient. In addition, in some cases, surgical management may be necessary. Recently, endoscopic treatment of liver abscesses, especially those secondary to biliary system pathologies, via sphincterotomy, dilatation of strictures, stent replacement, and nasobiliary drain replacement to the abscess pouch, has became a current issue of interest. In this case series, we aimed to present the clinical course of three patients with pyogenic liver abscess secondary to ascending cholangitis who were managed by nasobiliary drain replacement to the abscess pouch.
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