D’Egidio分型指导胰腺假性囊肿治疗方案选择  

Guidance of D' Egidio's classification to the treatment of pancreatic pseudocysts.

作　　者：章爱斌[1] 郑树森[1] 

机构地区：[1]浙江大学医学院附属第一医院肝胆外科,杭州310003

出　　处：《中国实用外科杂志》2004年第10期605-607,共3页Chinese Journal of Practical Surgery

摘　　要：目的　探讨胰腺假性囊肿 (PPC)的治疗方法和其基础疾病的关系。方法　收集浙江大学医学院附属第一医院 1992～ 2 0 0 3年收治的 73例PPC的临床资料 ,根据D’Egidio分型方法分型 ,前瞻性分析其基础疾病、主胰管解剖和治疗成功率的相关关系。结果　 37例D’EgidioⅠ型PPC中 16例进行手术引流 ,8例发生并发症或复发 ,治疗成功率为 5 0 % (8/ 16 ) ;另 11例行经皮穿刺引流 ,治疗成功率 82 % (9/ 11)。 2 4例Ⅱ型PPC中 9例行经皮穿刺或手术外引流 ,5例发生并发症或复发 ,治疗成功率为 4 4 % (4 / 9) ;另 12例经手术内引流或切除治疗 ,治疗成功率为 92 % (11/ 12 )。 12例Ⅲ型PPC ,10例经手术内引流或切除治疗 ,2例复发 ,治疗成功率为 80 % (8/ 10 )。结论　对胰腺假性囊肿基础疾病的分型可以指导其治疗。了解胰腺假性囊肿的基础疾病 ,对Ⅱ型、Ⅲ型PPC行ERCP明确胰管解剖 ,有利于正确选择治疗方案 。Objective To explore the relation between treatment and underlying diseases of pancreatic pseudocysts (PPC). Methods Clinical data of 73 cases of PPC admitted from 1992 to 2003 were collected. Based on D'Egidio's criteria, all the cases were classified. The relationship between classification of underlying diseases, anatomy of main pancreatic duct and successful rate of management were analyzed prospectively. Results Sixteen out of 37 D’Egidio’s typeⅠPPC patients were performed surgical drainage. Among these sixteen patients, 8 patients experienced complication or recurrence. The successful rate of management was 50% (8/16). Percutaneous catheter drainage was applied in the other eleven patients and the successful rate was 82% (9/11). Nine out of 24 typeⅡ PPC patients were treated with percutaneous or surgical external drainage, and five of them experienced complication or recurrence. The successful rate of management was 44% (4/9). Surgical internal drainage or excision was applied in 12 typeⅡPPC patients and the successful rate was 92% (11/12). In 12 type Ⅲ PPC patients, 10 were treated with surgical internal drainage or excision. Two of them experienced recurrence. The successful rate of management was 80% (8/10). Conclusion The classification of the PPC according to its underlying diseases is instructive for its treatment. Comprehending the underlying diseases of PPC, detecting the pancreatic duct pathology in typeⅡand type Ⅲ PPC with ERCP are help to choosing an appropriate method of treatment, and decreasing the rate of complication and recurrence as well.

关 键 词：治疗 胰腺假性囊肿 基础疾病 成功率 并发症 分型 复发 指导 结论 医学院 

分 类 号：R657[医药卫生—外科学] R735.7[医药卫生—临床医学]