Chowbey P K, Soni V, Sharma A, Khullar R, Baijal M, Vashistha A
Department of Minimal Access Surgery, Sir Ganga Ram Hospital, New Delhi, India.
J Laparoendosc Adv Surg Tech A. 2001 Aug;11(4):201-5. doi: 10.1089/109264201750539709.
Mature symptomatic pancreatic pseudocysts require surgical intervention for their management. In this era of minimal access surgery, several reports are now available of laparoscopic management of pancreatic pseudocysts.
We have performed this procedure in five patients over the past 2 years. Four patients developed the pseudocyst after acute alcoholic pancreatitis and one following acute biliary pancreatitis. The diameter of the pseudocyst ranged from 8 to 12 cm. The procedure was performed using five ports. The Harmonic Scalpel was used to create two ports in the anterior stomach wall through which two balloon trocars were placed into the gastric lumen. Following balloon inflation, the trocars were used to lift up the anterior gastric wall. This created the space for the cystogastrostomy to be fashioned laparoscopically through the balloon trocar. The ball probe of the Harmonic Scalpel was used to puncture the cyst through the posterior gastric wall. The cystogastrostomy was completed by firing an Endo-GIA30 stapler across the fused posterior gastric wall and anterior wall of the cyst.
The mean operative time was 90 minutes (range 80-125 minutes). The mean postoperative stay was 3.0 days. One patient had intraoperative bleeding at the anastomotic site, which was easily controlled.
Laparoscopic cystogastrostomy offers a feasible and safe therapeutic option for selected patients with large symptomatic pancreatic pseudocysts.
成熟且有症状的胰腺假性囊肿需要手术干预进行治疗。在这个微创手术的时代，现在有几篇关于腹腔镜治疗胰腺假性囊肿的报道。
在过去2年里，我们对5例患者实施了该手术。4例患者在急性酒精性胰腺炎后出现假性囊肿，1例在急性胆源性胰腺炎后出现。假性囊肿直径为8至12厘米。手术通过5个端口进行。使用超声刀在前胃壁制造两个端口，通过这两个端口将两个球囊套管针置入胃腔。球囊充气后，用套管针提起胃前壁。这为通过球囊套管针在腹腔镜下进行囊肿胃吻合术创造了空间。使用超声刀的球头探针经胃后壁穿刺囊肿。通过在融合的胃后壁和囊肿前壁发射Endo - GIA30吻合器完成囊肿胃吻合术。
平均手术时间为90分钟（范围80 - 125分钟）。平均术后住院时间为3.0天。1例患者在吻合口处出现术中出血，很容易得到控制。
对于部分有症状的大型胰腺假性囊肿患者，腹腔镜囊肿胃吻合术提供了一种可行且安全的治疗选择。
