Parks R W, Tzovaras G, Diamond T, Rowlands B J
Surgical Unit, Mater Hospital, Belfast, UK.
Ann R Coll Surg Engl. 2000 Nov;82(6):383-7.
This review analyses the outcome for patients with acute and chronic pancreatic pseudocysts managed in two major referral centres.
From 1987 to 1997, 33 patients were treated with either acute (n = 19) or chronic (n = 14) pseudocysts. Procedures performed included cystgastrostomy (64%), cystduodenostomy (6%), cystjejunostomy (3%), distal pancreatectomy with resection of pseudocyst (12%), laparotomy with external drainage (9%), endoscopic transpapillary stenting (3%) and endoscopic pancreatic duct sphincterotomy with percutaneous drainage of the pseudocyst (3%).
All patients had resolution of their pseudocyst and no patient developed recurrence. There were no deaths in this series. There was a 9% incidence of major complications and a 21% incidence of minor complications. Outcome was excellent in 63% and good in 27% of patients. Two patients (6%) had persistent chronic pain and one patient (3%) had evidence of exocrine pancreatic insufficiency with malabsorption.
Surgical internal drainage of pancreatic pseudocysts can be performed safely with low morbidity and mortality provided patients are carefully selected and their medical management is optimized. Although minimally invasive techniques now offer a variety of treatment options, open surgical drainage is still indicated for a significant number of cases.
本综述分析了在两个主要转诊中心接受治疗的急慢性胰腺假性囊肿患者的治疗结果。
1987年至1997年，33例患者接受了急性（n = 19）或慢性（n = 14）假性囊肿的治疗。所实施的手术包括囊肿胃吻合术（64%）、囊肿十二指肠吻合术（6%）、囊肿空肠吻合术（3%）、远端胰腺切除术加假性囊肿切除术（12%）、剖腹术加外引流术（9%）、内镜经乳头支架置入术（3%）以及内镜胰管括约肌切开术加经皮假性囊肿引流术（3%）。
所有患者的假性囊肿均消退，无患者复发。本系列无死亡病例。主要并发症发生率为9%，次要并发症发生率为21%。63%的患者治疗效果极佳，27%的患者效果良好。2例患者（6%）持续存在慢性疼痛，1例患者（3%）有胰腺外分泌功能不全伴吸收不良的证据。
只要仔细选择患者并优化其医疗管理，胰腺假性囊肿的手术内引流可以安全地进行，发病率和死亡率较低。尽管微创技术现在提供了多种治疗选择，但对于大量病例仍需进行开放手术引流。
