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十二指肠乳头囊肿引流术治疗胰腺假性囊肿 被引量:6

Treating of pancreatic pseudocyst through endoscopic transpapillary cyst drainage (ETCD)
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摘要 目的 探讨内镜下经十二指肠乳头囊肿引流术(ETCD)治疗胰腺假性囊肿(PPC)的疗效。方法 26例ETCD治疗患者囊肿大小为1.5-15 cm,23例为直接行ETCD引流,1例因并发黄疸同时行胆管内置管,2例因囊肿外压胃窦及十二指肠而致乳头无法显示,其中1例先行经皮囊肿穿刺术,囊肿缩小后找见乳头,再行ETCD引流。观察术后囊肿消退及临床症状改善情况。结果 治疗后23例患者囊肿消退,腹痛、胃纳、脂肪泻及体重情况均明显改善,1例改善不明显,2例无改善。随访60-850 d,1例囊肿复发,1例并发胰腺脓肿,3例引流术后需行手术治疗。结论 ETCD治疗交通性似性囊肿是安全、有效的首选治疗方法,对于不交通PPC无效。 Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.
出处 《中华消化内镜杂志》 2004年第6期378-380,共3页 Chinese Journal of Digestive Endoscopy
关键词 十二指肠乳头囊肿引流术 治疗 胰腺假性囊肿 疗效观察 Pancreatic pesudocyst Endoscopic transpapillary cyst drainage
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参考文献5

  • 1Smits ME, Rauws EA, Tytgat GN, et al. The efficacy of endoscopic treatment of pancreatic pseudocysts. Gastrointest Endosc, 1995,42:202-207.
  • 2Catalano MF, Geenen JE, Schmalz M J, et al. Treatment of pancreatic pseudocysts with ductal communication by transpapillary pancreatic duct endoprosthesis. Gastrointest Endosc, 1995,42:214-218.
  • 3Barthet M, Sahel J, Bodiou-Bertei C, et al. Endoscopic transpapillary drainage of pancreatic pseudocysts. Gastrointest Endosc, 1995,42:208-213.
  • 4Binmoeller KF,Seifert H,Walter A, et al. Transpapillary and transmural drainage of pancreatic pseudocysts. Gastrointest Endosc, 1995,42:219-224.
  • 5Pfaffenbach B, Langer M, Stabenow-Lohbauer U, et al. Endosonography controlled transgastric drainage of pancreatic pseudocysts. Dtsch Med Wochenschr, 1998,123:1439-1442.

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