Ammori B J, Bhattacharya D, Senapati P S P
Royal Gwent Hospital, Newport, United Kingdom.
Surg Laparosc Endosc Percutan Tech. 2002 Dec;12(6):437-40. doi: 10.1097/00129689-200212000-00010.
The transgastric pseudocyst-gastrostomy is the standard approach for internal drainage of persistent and large retrogastric pancreatic pseudocysts that complicate acute necrotizing pancreatitis. We report on the application of a laparoscopic endogastric approach for drainage of pancreatic pseudocysts and discuss the merits of this technique as well as of the other previously described minimally invasive approaches for the management of pancreatic pseudocysts. Between January 2001 and August 2001, three female patients presented with large symptomatic pseudocysts 3-10 months after an episode of acute necrotizing pancreatitis. Internal drainage was effected by a laparoscopic endogastric pseudocyst gastrostomy, and the necrotic pancreas was debrided. There were no conversions and no postoperative complications. The median postoperative hospital stay was 4 days (range, 3-5). All patients remain asymptomatic, and resolution of the pseudocyst was radiologically evident at a median follow-up of 6 months (range, 4-11). The laparoscopic endogastric pseudocyst gastrostomy appears to be a safe and effective minimally invasive approach for internal drainage of large retrogastric pancreatic pseudocysts and facilitates debridement of the necrotic pancreas.
经胃假性囊肿胃造口术是持续性、较大的胃后胰腺假性囊肿（这是急性坏死性胰腺炎的并发症）内引流的标准方法。我们报告了腹腔镜内胃途径在胰腺假性囊肿引流中的应用，并讨论了该技术以及其他先前描述的微创方法在处理胰腺假性囊肿方面的优点。在2001年1月至2001年8月期间，3例女性患者在急性坏死性胰腺炎发作后3至10个月出现有症状的大型假性囊肿。通过腹腔镜内胃假性囊肿胃造口术进行内引流，并对坏死胰腺进行清创。没有中转开腹情况，也没有术后并发症。术后中位住院时间为4天（范围3至5天）。所有患者均无症状，在中位随访6个月（范围4至11个月）时，假性囊肿在影像学上明显消退。腹腔镜内胃假性囊肿胃造口术似乎是大型胃后胰腺假性囊肿内引流的一种安全有效的微创方法，并有助于坏死胰腺的清创。
