胰腺假性囊肿的综合处理  

Combined therapy of pancreatic pseudocyst

作　　者：吕云福[1] 李新秋[2] 宫晓光[2] 黄海[1] 

机构地区：[1]海南省人民医院普外科, 海口570311 [2]西安交通大学第一医院肝胆外科

出　　处：《国际外科学杂志》2007年第9期589-592,共4页International Journal of Surgery

摘　　要：目的探讨胰腺假性囊肿的综合处理。方法回顾性总结近7年来我院收治胰腺假性囊肿36例的临床资料。结果急性胰腺炎后28例,慢性胰腺炎后3例,腹部外伤后5例。囊肿直径≤6cm者10例,均为单房性囊肿;直径〉6cm者26例,其中9例为多房、17例为单房性囊肿。ERCP造影显示67%囊肿与主胰管沟通,绝大多数发生在〉6cm的囊肿。囊肿直径≤6cm的10例病人,除1例作了囊肿切除和2例并发感染行外引流治愈外,7例皆经保守治愈;〉6cm的26例病人,除1例保守治愈外,其余25例均行囊肠Roux-en-Y吻合术,无手术死亡。结论不与胰管沟通或直径≤6cm的囊肿,可行非手术治疗;与胰管沟通或直径〉6cm的囊肿,6周后不消退均应行内引流术或内镜治疗;术前了解囊肿与胰管的沟通情况十分必要。Objective To explore the combined therapy of pancreatic pseudocyst. Methods The clinical data of 36 patients with pancreatic pseudocyst in our hospital in the past seven years were retrospectively analyzed. Results Twenty - eight patients were caused by acute pancreatitis, 3 by chronic pancreatitis and 5 by abdominal trauma. Ten patients＇ pseudocysts were less than 6 cm in diameter in 10 patients, and were all unilocular. Among 26 patients with pseudocysts more than 6 cm in diameter, 17 patients＇ pseudocysts were unilocular, 9 were muhilocular. There was 67% of all the pseudocysts communicated with the main pancreatic ducts and most were Larger than 6 cm in diameter under endoscopic retrograde cannulation of the pancreatic duct （ERCP） visualization. In the ten patients with cysts less than 6 cm in diameter, 1 was cured by cystectomy, 2 by external drainage though complicated with infection, 7 by conservative therapy. Among the 26 patients Larger than 6 cm in diameter, 1 was cured by conservative therapy, the rest 25 all performed Roux - en - Y anastomosis without operative mortality. Conclusions Patients with pancreatic pseudocysts not communicated with the main pancreatic ducts or less than 6 cm in diameter should be managed with conservative therapy, while those communicated with main pancreatic ducts or Larger than 6 cm in diameter and without decrescence in 6 weeks should be treated by internal drainage or therapeutic endoscopy. It was necessary to evaluate the communication between pseudocysts and main pancreatic ducts before operation.

关 键 词：胰腺假性囊肿 综合处理 主胰管 

分 类 号：R57[医药卫生—消化系统]