胰腺占位性病变的超声内镜引导下穿刺诊断与治疗

Diagnosis and treatment guided by endoscopic ultrasonography in location lesion of pancreas

目的 评价胰腺占位性病变的超声内镜引导下穿刺诊断与治疗价值。方法 采用OlympusGF UM 30P穿刺超声内镜及 18G穿刺针对胰腺占位性病灶经胃壁穿刺活检及置入塑料支架行胰腺囊肿胃内引流术。结果 ①所穿刺病灶最小径胰腺癌为 3cm ,囊肿为 2 .3cm ;②穿刺成功率、取样满意率和诊断准确率均达 10 0 %;③胰腺囊肿穿刺后最大径减少均超过 5 0 %,2例囊肿消失 ,术后 1、2、3个月复查 5例中4例囊肿增大 ,术后 3个月 2例囊肿达术前大小 ,术后 1年 2例囊肿仍较术前减小 5 0 %;④ 1例行囊肿胃置管内引流术者术后 1周囊肿缩小 5 0 %,6个月无复发 ;⑤ 11例穿刺者未发生任何近期和远期并发症。结论超声内镜引导下穿刺对胰腺占位性病变的诊断与治疗均有较大价值。

Objective To investigate significance of diagnosis and treatment guided by endoscopic ultrasonography(EUS) in location lesion of pancreas.Methods Transgastric aspiration biopsy and placing plastic stent were done by endoscopic ultrasonography (Olympus GF UM30P) with 18G needle.Results The least size of the pancreatic cancer was 3 cm and that of the pancreatic cyst was 2.3 cm.The successful rate of puncture and accuracy of diagnosis are both 100%.The diameters of all of the pancreatic cysts were less than 50% of that after the operation. Two pancreatic cysts disappeared.Four of five pancreatic cysts were larger than before after 1,2,3 months.Two pancreatic cysts were the same as those before operation. Transgastric placing plastic stent was done in one patient,and its cyst was less than 50% after 1 week.Two pancreatic cysts were less than 50% after one year.There was no early and delay complications. Conclusions Diagnosis and treatment guided by EUS in location lesion of pancreas is usefull.