Treatment of pancreatic and peripancreatic infections secondary to severe acute pancreatitis by ultrasound-guided puncture & catheterization and debridement under choledochoscope：an analysis of 22 cases TANG Li-jun, WANG Tao, TIAN Fu-zhou, et al. Center of General Surgery, Chengdu General Hospital of PLA Chengdu Command, Chengdu 610083, China Corresponding author: TANG Li-jun, E-mail: whjtlj@yahoo.com.cn Abstract Objective To introduce and summarize a new method in treatment of pancreatic and peripancreatic infections secondary to severe acute pancreatitis. Methods The treatments of 22 cases of pancreatic and peripancreatic infections secondary to severe acute pancreatitis admitted between 2004 and 2007 at Chengdu General Hospital of PLA Chengdu Command were analyzed. The treatment procedure included as following: puncturing and placing a catheter through B-ultrasonic guidance for drainage of pancreatic and peripancreatic infections, and then removing the catheter after 3-5 days, expanding the sinus tract of the catheter with a skin expander, and then placing a large-diameter tube for drainage, removing the large-diameter tube and debriding under a choledochoscope in the next week. Results Of all the 22 cases treated by the above method, pancreatic and peripancreatic infections were effectively drained or removed. Among them, 15 cases were relieved of pancreatic and peripancreatic infections completely. Four cases underwent open-abdominal surgery for drainage as the residual abscess was located in the hilus lienis or iliac fossa difficult to debride under choledochoscope. Three cases underwent cysto-jejunostomy due to formation of pancreatic pseudocyst. Conclusion Ultrasound-guided puncture & catheterization and debridement under choledochoscope is a simply, safe and reliable treatment method for pancreatic and peripancreatic infections secondary to severe acute pancreatitis.