Ureteroscope-aided Reinsertion of Dislodged Pigtail Nephrostomy Tube Through Collapsed Tract
Vol. 16 No. 3 (2019),
17 June 2019
Purpose: To introduce an alternative method for the reinsertion of pigtail catheter for collapsed nephrostomy tract.
Materials and Methods: Between January 2013 and October 2016, a total of ten patients with collapsed nephrostomy tract underwent ureteroscope-aided reinsertion of the pigtail catheter after the failure of manual reinsertion by guidewire. Under local anesthesia, the ureteroscope was inserted through a percutaneous nephrostomy (PCN) opening. The access path was obtained by careful tracing for prior placement of pigtail catheter. The clinical features of these ten patients, including operation time, success rate and complications, were evaluated by retrospective chart review. The Clavien classification was applied to define the grade of complications after one-month follow-up.
Results: Among the ten cases of difficult PCN revision, eight underwent the procedure within 24 hours of the dislodgement. The remaining two patients underwent the procedure within 2 days and 8 days. The period of pigtail tube dwelling ranged from 2 weeks to 10.5 months. The procedure was successful in nine cases and the operation time ranged from 10 to 30 minutes. No fluoroscope was used in any patient. All of the nine patients had a good drainage function after tube reinsertion. Complications occurred only in one patient who had postoperative fever classified as Clavien grade 2.
Conclusion: Reinserting the dislodged pigtail nephrostomy tube with the aid of an ureteroscope is an alternative method that may decrease the necessity of new tract creation.
How to Cite
Dagli M, Ramchandani P. Percutaneous nephrostomy: technical aspects and indications. Semin Intervent Radiol 2011; 28:424-37.
Ramchandani P, Cardella JF, Grassi CJ, et al. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 2003; 14:S277-81.
Zagoria RJ, Dyer RB. Do's and don't's of percutaneous nephrostomy. Acad Radiol 1999; 6:370-77.
Farrell TA, Hicks ME. A review of radiologically guided percutaneous nephrostomies in 303 patients. J Vasc Interv Radiol 1997; 8:769-74.
Lee WJ, Patel U, Patel S, Pillari GP. Emergency percutaneous nephrostomy: results and complications. J Vasc Interv Radiol 1994; 5:135-9.
Lewis S, Patel U. Major complications after percutaneous nephrostomy—lessons from a department audit. Clin Radiol 2004; 59:171-9.
Radecka E, Magnusson A. Complications associated with percutaneous nephrostomies: A retrospective study. Acta Radiol 2004; 45:184-8.
Karim R, Sengupta S, Samanta S, Aich RK, Das U, Deb P. Percutaneous nephrostomy by direct puncture technique: An observational study. Indian J Nephrol 2010; 20:84-8.
Collares FB, Faintuch S, Kim SK, Rabkin DJ. Reinsertion of accidentally dislodged catheters through the original track: what is the likelihood of success? J Vasc Interv Radiol 2010; 21:861-4.
Tenke P, Riedl CR, Jones GL, Williams GJ, Stickler D, Nagy E. Bacterial biofilm formation on urologic devices and heparin coating as preventive strategy. Int J Antimicrob Agents 2004; 23:67-74.
Jones SR, Smith JW, Sanford JP. Localization of urinary-tract infections by detection of antibody-coated bacteria in urine sediment. N Engl J Med 1974; 290:591-3.
Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW. The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 1998; 16:371-4.
Kirac M, Bozkurt ÖF, Tunc L, Guneri C, Unsal A, Biri H. Comparison of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy in management of lower-pole renal stones with a diameter of smaller than 15 mm. Urolithiasis 2013; 41:241-6.
- Abstract Viewed: 563 times
- PDF/4258 Downloaded: 250 times