摘要
AIM: Pancreatic pseudocysts (PPC) as a complication of pancreatitis are approached only in the case of abdominal pain, infection, bleeding, and compression onto the gastrointestinal tract or biliary tree. METHODS: From 02/01/2002 to 05/31/2004, all con- secutive patients with symptomatic PPC who underwent an interventional endoscopic approach were evaluated in this pilot case-series study: Group (Gr.) Ⅰ-Primary percutaneous (external), ultrasound-guided drainage. Gr. Ⅱ- Primary EUS-guided cystogastrostomy. Gr. Ⅲ-EUS-guided cystogastrostomy including intracystic necrosectomy. RESULTS: (="follow up": n = 27): Gr. Ⅰ (n = 9; 33.3%): No complaints (n = 3); change of an external into an internal drainage (n = 4); complications: (a) bleeding (n = 1) followed by 3 d at ICU, discharge after 40 d; (b) septic shock (n = 1) followed by ICU and several laparotomies for programmed lavage and necrosectomy, death after 74 d. Gr. Ⅱ (n = 13; 48.1%): No complaints (n = 11); external drainage (n = 2); complications/problems out of the 13 cases: 2nd separate pseudocyst (n = 1) with external drainage (since no communication with primary internal drainage); infection of the residual cyst (n = 1) + following external drainage; spontaneous PPC perforation (n = 1) + following closure of the opening of the cystogastrostomy using clips and subsequently ICU for 2 d. Gr. Ⅲ (n = 5; 18.5%): No complaints in all patients, in average two endoscopic procedures required (range, 2-6). CONCLUSION: Interventional endoscopic management of pancreatic pseudocysts is a reasonable alternative treatment option with low invasiveness compared to surgery and an acceptable outcome with regard to the complication rate (11.1%) and mortality (3.7%), as shown by these initial study results.
瞄准:胰腺的假包囊(PPC ) 仅仅在腹的疼痛的情况中作为胰腺炎的复杂并发症被接近,感染,流血,并且压缩到胃肠道或胆汁的树上。方法:从 02/01/2002 到 05/31/2004,经历了 interventional 的有征兆的 PPC 的所有连续病人内视镜的途径在这飞行员盒子系列研究被评估:组(Gr ) 我主要经皮(外部) ,指导超声的排水。Gr。II 主要的指导 EUS 的胰囊肿胃吻合术。Gr。包括 intracystic necrosectomy 的 III-EUS-guided 胰囊肿胃吻合术。结果:( = “列在后面在上面”:n = 27 ) :Gr。我(n = 9;33.3%) :没有抱怨(n = 3 ) ;变化一进内部排水外部(n = 4 ) ;复杂并发症:(a) 流血(n = 1 ) 在 ICU 由 3 d 列在后面,在 40 d 以后的分泌物;(b) 腐败吃惊(n = 1 ) 由 ICU 和几剖腹术列在后面规划洗室年龄和 necrosectomy,在 74 d 以后的死亡。Gr。II (n = 13;48.1%) :没有抱怨(n = 11 ) ;外部排水(n = 2 ) ;从 13 个盒子的复杂并发症 / 问题:第二分开的假包囊(n = 1 ) 与外部排水(自从与主要内部排水的没有通讯) ;剩余包囊的感染(n = 1 )+ 追随者外部排水;自发的 PPC 穿孔(n = 1 ) 用片断并且随后的胰囊肿胃吻合术的开始的 + 追随者闭合为 2 d 的 ICU。Gr。III (n = 5;18.5%) :在所有病人的没有抱怨,在要求的一般水准二内视镜的过程(变化, 2-6 ) 。结论:胰腺的假包囊的 Interventional 内视镜的管理关于复杂并发症率(11.1%) 和死亡(3.7%) 是有与外科和可接受的结果相比的低侵略海角的一种合理其他的治疗选择,作为由这些证明起始的学习结果。