超声内镜下经胃、十二指肠乳头引流治疗胰腺假性囊肿的有效性和安全性

Effectiveness and Safety of Endoscopic Ultrasound-guided Transgastric or Transpapillary Drainage in Treating Pancreatic Pseudocyst

目的探讨超声内镜下经胃或十二指肠乳头置管引流治疗胰腺假性囊肿的有效性和安全性。方法 2004年6月至2013年2月中国人民解放军总医院在超声内镜引导下经胃或十二指肠乳头穿刺置管引流治疗15例胰腺假性囊肿患者。以"胰腺假性囊肿"并"引流"为主题词检索中国知识仓库医学专题全文数据库(1994至2012年)以及维普中文科技期刊数据库(1989至2012年)。共纳入5篇文献,103例患者。回顾性分析118例患者的疗效及并发症。结果经胃穿刺置管引流94例,经十二指肠乳头穿刺置管引流24例。成功率为94.9%,囊肿完全消失率为83.9%。并发症发生率为19.5%,多为术中出血、支架移位堵塞、继发囊肿内感染。1例失访、1例复发。结论超声内镜下经胃、十二指肠乳头穿刺置管引流术是治疗胰腺假性囊肿的有效方法。

Objective To explore the effectiveness and safety of endoscopic transgastric or transpapillary drainage in treating pancreatic pseudocysts. Methods The clinical data of 15 patients with pancreatic pseudocyst who underwent endoscopic ultrasound-guided transgastrie or transpapillary drainage in the Chinese PLA General Hospital between June 2004 and February 2013 were retrospectively analyzed. Also, we reviewed the relevant Chinese literature in the China Academic Journal Network Publishing Database （from 1994 to 2012 ） and VIP China Science and Technology Journal Database （ from 1989 to 2012） using the key words ＂pancreatic pseudocyst and drainage＂ . Five literatures including 103 cases were enrolled. Results The data of 118 cases undergoing endoscopic drainage, included 94 cases with transgastric approach and 24 with transpapillary approach, entered the final analysis. The success rate was 94.9% , and cysts completely disappeared in 83.9% of the patients. The overall incidence of complications （ bleeding, infection, and stent clogging or migration） was 19. 5%. One patient lost to follow-up and only one case of recurrence was noted. Conclusion Endoscopic transgastric or transpapillary drainage is safe and effective in treating the pancreatic pseudocysts and therefore can be a preferred therapeutic approach.