免X线超声内镜下透壁引流治疗胰腺假性囊肿的单中心回顾性分析  

Retrospective analysis of X-ray free transmural drainage of pancreatic pseudocysts using echoendoscope

作　　者：郝杰[1] 马坚 周灿灿[1] 段万星[1] 王铮[1] 孙昊[1] 李宇[1] 陶杰[1] 杨雪[1] 董鼎辉[1] 仵正[1] Hao Jie;Ma Jian;Zhou Cancan;Duan Wanxing;Wang Zheng;Sun Hao;Li Yu;Tao Jie;Yang Xue;Dong Dinghui;Wu Zheng(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,陕西西安710061

出　　处：《中国内镜杂志》2023年第10期76-82,共7页China Journal of Endoscopy

基　　金：国家自然科学基金(No:82072702)。

摘　　要：目的探讨免X线超声内镜下胰腺假性囊肿(PPC)透壁引流,对比传统X线引导下透壁引流的临床效果和安全性。方法回顾性分析2018年1月-2021年6月就诊于该院的33例行超声内镜下PPC透壁引流术患者的临床资料。其中,免X线组14例和X线引导组19例,比较两组患者手术成功率、手术时间和并发症发生率等。结果33例PPC患者均成功完成手术(100.00%),免X线组手术时间为(28.30±13.00)min,明显短于X线引导组的(46.79±18.00)min,差异有统计学意义(P<0.05)。免X线组2例(14.29%)出现术后并发症。其中,1例患者由于合并部分包裹性坏死,治疗后出现了感染和发热,抗感染治疗效果不理想,再次进行超声内镜下鼻胆管引流后,症状改善;另1例由于合并区域性门静脉高压症,术后出现上消化道出血,行介入治疗后,痊愈出院。X线引导组术后并发症4例(21.05%)。其中,2例因出现囊腔内感染而再次引流;2例出现上消化道出血,1例保守治疗成功,1例行开腹手术止血治疗和囊肿外引流术。结论单纯性PPC行免X线超声内镜下透壁引流术,安全、有效,手术时间短,且内镜医生能够避免X线辐射损伤,值得临床推广。Objective To investigate the clinical effect and safety of transmural drainage of pancreatic pseudocysts(PPC)under X-ray free echoendoscope compared with X-ray guided transmural drainage of PPC.Methods Clinical data of 33 patients diagnosed with PPC from January 2018 to June 2021 were collected and analyzed retrospectively.14 patients underwent X-ray free transmural drainage using echoendoscope while 19 patients got treatment with X-ray.The surgical success rate,operation time and complications were analyzed.Results All the 33 patients(100.00%)with PPC were successfully operated.The average operation time of X-ray free group was(28.30±13.00)min which is obviously shorter than that of X-ray group(46.79±18.00)min(P<0.05).Only two cases had complications(14.28%)in X-ray free group,one patient had infection and fever after treatment,which improved after endoscopic nasobiliary drainage(ENBD).Another case with regional portal hypertension got postoperative bleeding,which was relieved after interventional treatment.Four cases in X-ray group had complications(21.05%),two of them received re-drainage due to infection,two of them showed upper gastrointestinal bleeding,2 cases experienced upper gastrointestinal bleeding,1 case was successfully treated conservatively,and 1 case underwent open surgery for hemostasis and external cyst drainage.Conclusion The X-ray free transmural drainage of PPC using echoendoscope is safe and effective,takes shorter time of operation,and the operator is able to avoid the damage of X-ray,which is worthy of clinical promotion.

关 键 词：胰腺假性囊肿(PPC) 透壁引流 超声内镜 免X线引导手术 胰腺假性囊肿引流术 术后并发症 

分 类 号：R657.52[医药卫生—外科学]