Gooszen H G, Schmitz R F, Smit P C, Schipper M E, van Leeuwen M S, van Laarhoven C J
Afd. Heelkunde, Academisch Ziekenhuis, Utrecht.
Ned Tijdschr Geneeskd. 1999 May 1;143(18):925-30.
Owing to the spectacular progress in imaging techniques, cystic lesions of the pancreas are detected more often than previously, and this leads to therapeutic dilemmas. Of the cystic lesions of the pancreas, 80% are found to be pseudocysts and 10-15%, neoplastic cysts. The definition of a pseudocyst is: 'an accumulation of pancreatic juice surrounded by a wall of connective tissue or granulation tissue, developed as the result of acute pancreatitis, pancreatic injury or chronic pancreatitis'. In cases of asymptomatic pseudocyst, an expectative policy suffices; growth and symptomatic pseudocysts justify intervention. In addition to surgical internal drainage (cystojejunostomy) there are new therapeutic techniques: external drainage guided by ultrasonography or CT, and internal drainage guided by endoscopy. Endoscopic drainage is the treatment of choice, but it requires experienced hands. The cystic tumours are subdivided into two groups: serous and mucinous cystadenomas. The group of mucinous tumours is subdivided into mucinous cystadenomas and intraductal papillary mucinous tumours. The mucinous or macrocystic adenoma is potentially malignant and should be treated as a malignancy.
由于成像技术的显著进步，胰腺囊性病变的检出率比以前更高，这导致了治疗困境。在胰腺囊性病变中，80%被发现是假性囊肿，10 - 15%是肿瘤性囊肿。假性囊肿的定义是：“由结缔组织或肉芽组织壁包围的胰液积聚，由急性胰腺炎、胰腺损伤或慢性胰腺炎引起”。对于无症状的假性囊肿，采取观察等待策略即可；囊肿增大且出现症状的假性囊肿则需要进行干预。除了手术内引流（囊肿空肠吻合术）外，还有新的治疗技术：超声或CT引导下的外引流，以及内镜引导下的内引流。内镜引流是首选的治疗方法，但需要经验丰富的医生操作。囊性肿瘤可分为两组：浆液性和黏液性囊腺瘤。黏液性肿瘤组又分为黏液性囊腺瘤和导管内乳头状黏液性肿瘤。黏液性或大囊性腺瘤有潜在恶性可能，应按恶性肿瘤进行治疗。
