胰腺假性囊肿的外科治疗83例分析

Analysis of 83 Cases Surgical Treatment of Pancreatic Pseudocyst

目的:探讨对胰腺假性囊肿的治疗方式和效果。方法:结合有关文献及对我院1990年1月至2007年6月收治的83例胰腺假性囊肿的处理方式、效果及并发症进行回顾性分析。结果:期待疗法自愈4例,采用非手术和非介入的期待处理10例,5例囊肿明显缩小,5例囊肿消失;B超引导下经皮囊肿穿刺抽液1例。B超引导下经皮置管引流3例;外引流术5例。单纯囊肿切除术6例。囊肿胰尾脾切除术3例。其余均行内引流术:囊肿与胃吻合23例。囊肿与空肠Roux-en-Y吻合28例,囊肿与十二指肠吻合2例,均获一次性治愈,无近期、远期并发症发生。结论:应采用个体化的治疗原则,根据囊肿形成的大小、时间、部位选择期待疗法、非手术引流(经皮穿刺吸液、内镜治疗),胃囊肿吻合、十二指肠囊肿吻合、空肠囊肿吻合、囊肿切除术。

Objective：To evaluate the way and the result and surgical treatment of pancreatic pseudoeyst. Methods：Combined with the related literature, the treatment way, effect and syndrome of 83eases diagnosed as the pancreatic pseudocyst and treated by surgical method from January. 1990 to June 2007 were retrospectively analyzed. 4 cases of expectant therapy were self - healed. There were 5 cases that cysts reduced obviously and 5cases that cysts disappeared in the 10 cases treated using non - operation and non - intercurrent expectant therapy. There were 3 cases,using B - US guided percutaneous drainage , 5 cases using external drainage ,6 cases using simply cyst excision, 3 cases using excision of body and tail of pancrea ＋ splenectomy. The rest using internal drainage： 23 cases using cystogastrostomy, 28 cases using Roux - en - Y cystojejunostomy, 2 cases using pancreatoduodenectomy. All were one - off healed without recent and long term syndrome recurrence. Conclusions： It should he using individual therapy principle that can select expectant therapy, non - operation drainage （ percutaneous puncture imbibitlon, endoscope therapy）, cystogastrostomy, pancreatoduodenectomy , cystojejunostomy and cyst excision according to the size , formed time and the position of cyst.