胰腺假性囊肿41例诊治体会  

Diagnosis and Treatment Experiences of Pancreatic Pseudocysts(41 Cases Report)

作　　者：向炳辉 周钧[2] 

机构地区：[1]湖南省岳阳市岳阳楼区人民医院普外科,岳阳414000 [2]中南大学湘雅二医院微创外科,长沙410011

出　　处：《中国现代手术学杂志》2011年第4期259-261,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胰腺假性囊肿的诊断及外科手术治疗方式。方法回顾性分析行手术治疗的41例胰腺假性囊肿患者的临床资料,其中行单纯囊肿外引流术7例(17.1%),单纯囊肿切除10例(24.4%),囊肿及胰尾部切除+脾切除术3例(7.3%),囊肿空肠Roux-en-Y吻合18例(43.9%),囊肿胃吻合3例(7.3%)。结果术后发生并发症8例(19.5%),1例囊肿胃吻合术患者术后2 d出现消化道出血,经非手术治疗而痊愈出院;2例患者(单纯囊肿外引流术1例,囊肿空肠Roux-en-Y吻合1例)早期出现不全性肠梗阻,经过保守治疗出院;2例单纯囊肿外引流术患者术后出现胰瘘,1例胰瘘经保守治疗治愈,另外1例因长期胰瘘而再行瘘管空肠吻合术而治愈;1例囊肿空肠Roux-en-Y吻合术后出现逆行感染,经抗炎保守治疗后病情缓解;全组切口感染2例,1例保守换药,另1例换药后行二期缝合均获痊愈。无手术死亡病例。随访37例,时间6个月～5年,平均(3.3±1.9)年,2例单纯囊肿切除术患者于术后1年复发,经保守治疗症状缓解。结论胰腺假性囊肿在经保守治疗渡过急性期后,应根据需要采取个体化的外科治疗方案。Objective To explore the diagnosis and treatment of pancreatic pseudocysts. Methods The clinical data of 41 cases of pancreatic pseudocysts were analyzed retrospectively. There were 7 cases （ 17. 1% ） of external drainage, 10 cases （24.4%） of single excision, 3 cases （7.3 % ） of resection of pancreatic tail and splenectomy, 18 cases （43.9%） of Roux-en-Y cyst-jejunostomy and 3 cases of cyst-gastrostomy （7.3%）. Results There were 8 cases （ 19.5% ） suffered from complications. One case of cyst-gastrestomy appeared gastrointestinal bleeding and was cured after non-surgical treatment. 2 patients （ simple external drainage in 1 case and cyst jejunum Roux-en-Y anastomosis in 1 case） occurred incomplete intestinal obstruction at the early stage after operation and discharged after successful conservative treatment. Two cases of simple cyst external drainage suffered postoperative pancreatic fistula, in which 1 case cured by conservative treatment and the other was cured by cyst-jejunostomy after long-term pancreatic fistula. 1 cyst jejunostomy patient occurred retrograde infection and got remission by anti-inflammatory conservative treatment. In the whole group, there were 2 cases of wound infection and cured of conservative dressing and secondary suture respectively. No operative death. 37 cases were followed up for 6 months to 5 years in whom 1 case recurred. Conclusion After the acute stage through expectant treatment, it should be used for pancreatic pseudocysts to select suitable operation.

关 键 词：胰腺假囊肿 引流术 

分 类 号：R657.5[医药卫生—外科学]