胰腺假性囊肿治疗方式的临床分析

CLINICAL ANALYSIS IN THE TREATMENT OF PANCREATIC PSEUDOCYST

目的对胰腺假性囊肿的治疗方式和临床效果进行分析。方法对2002年1月至2008年6月收治的42例胰腺假性囊肿的治疗方式、效果、并发症进行回顾性分析。结果非手术治疗4例,在随访期间均能自行吸收;手术治疗38例:包括胰腺假性囊肿-胃吻合9例,术后有1例出现吻合口出血;囊肿-十二指肠吻合2例;囊肿-空肠Roux-en-Y吻合21例,术后有2例出现吻合口出血;腹腔镜囊肿-胃内引流术1例;胰腺假性囊肿外引流术2例,术后有1例出现胰瘘;胰腺假性囊肿切除术3例,术后有1例出现胰漏。结论胰腺假性囊肿的治疗已趋于多样化,需根据患者的具体病情来选择不同的治疗方式;手术治疗中囊肿内引流术仍是主要术式,根据囊肿的具体情况选择不同的吻合方式;其中腹腔镜胰腺假性囊肿-胃内引流术,安全微创,疗效确切,值得推广。

Objective To analyze the different procedures and clinical effects in the treatment of pancreatic pseudocyst.Methods Retrospectively review the outcome of 42 patients with pancreatic pseudocyst treated in Beijing Chaoyang Hospital from January 2002 to June 2008.Results There were 4 patients undergoing non-surgical procedures and the pseudocysts absorbed spontaneously during follow up.Surgical procedures performed in 38 cases including cystgastrostomy（9 cases）with 1 post operative gastrointestinal bleeding,cystduodenostomy（2 cases）,Roux-en-Y cystjejunostomy（21 cases）with 2 postoperative gastrointestinal bleeding,laparoscopic cystogastrostomy（1 case）,external drainage（2 cases）with 1 postoperative pancreatic fistula,and excision（3 cases）with 1 postoperative pancreatic leakage.Conclusion At present,there are a variety of treatment options for pancreatic pseudocyst and it is necessary to select reasonable treatment according to patient′s condition.Internal drainage is still the primary treatment option in surgical procedures with selecting the optimal operation type according to different pseudocysts.Laparoscopic cystogastrostomy appears to be safe and effective and should be considered a choice of treatment in the management of pancreatic pseudocyst.