Dohmoto M, Akiyama K, Lioka Y
Diagnostic & Therapeutic Endoscopic Unit, Tohkatsu Clinic, Matsudo, Japón.
Rev Gastroenterol Peru. 2003 Oct-Dec;23(4):269-75.
The cause of pancreatic cyst were in 72 % due to alcoholism. A drainage to pancreatic cyst is very critical for patient with the stomach varices patient. The endoscopic ultrasonography(EUS) is a valuable supplement to the diagnostic procedure to localise the optimal spot for puncture and to avoid haemorrhage due to damage of intra or extra-mural blood vessels.
The drainage was reached by transpapillary endoscopic retrograde pancreatic drainage (ERPD), endoscopic cystogastrostomy (ECG) or endoscopic cystoduodenostomy (ECD). The case that varices is doubted and If the identification of the cyst is difficult the transmural drainage should be carried out under endosonographic control.
Between 1987 and 2002, 47 patients had been treated for panceatic pseudocysts by transmural or transductal drainage EUS-guided drainage of a pancreatic pseudocyst or pancreatc abscess was carried out in 5 cases. In 42patients pancreatic pseudocysts disappeared completely. Six patients suffered a relapse 7 to 38 months after removal of the drainage. No more recurrences were observed in 22 patients within followed up 5-11 years. In another 6 patients the prostheses were renewed because of occlusion or dislocation. Overall 6 patients had to undergo surgery, 3 patients due to relapsing cyst, 2 patients because of insufficient drainage and one patient because of severe bleeding. There was no case of death related to the endoscopic treatment.
The EUS is a valuable supplementation to the diagnostic procedure to localize the optimal spot for puncture and to avoid haemorrhage because of damage of intra or extramural bloodvessels. Advantages of the endoscopic drainage are minimal invasiveness, short period of hospitalization and low costs. These aspects make the endoscopic therapy the first choice of treatment of pancreatic pseudocysts.
72%的胰腺囊肿病因是酗酒。对于患有胃静脉曲张的患者，胰腺囊肿引流至关重要。内镜超声检查（EUS）是诊断程序的重要补充，可用于定位最佳穿刺点并避免因壁内或壁外血管损伤导致出血。
通过经乳头内镜逆行胰管引流（ERPD）、内镜下囊肿胃吻合术（ECG）或内镜下囊肿十二指肠吻合术（ECD）进行引流。对于怀疑有静脉曲张且囊肿识别困难的病例，应在超声内镜引导下进行经壁引流。
1987年至2002年期间，47例患者接受了经壁或经导管引流治疗胰腺假性囊肿，其中5例在超声内镜引导下对胰腺假性囊肿或胰腺脓肿进行了引流。42例患者的胰腺假性囊肿完全消失。6例患者在拔除引流管后7至38个月复发。在随访的5至11年中，22例患者未再复发。另外6例患者因假体堵塞或移位而更换。总体而言，6例患者需要接受手术，3例因囊肿复发，2例因引流不充分，1例因严重出血。没有与内镜治疗相关的死亡病例。
EUS是诊断程序的重要补充，可用于定位最佳穿刺点并避免因壁内或壁外血管损伤导致出血。内镜引流的优点是微创、住院时间短和成本低。这些方面使内镜治疗成为胰腺假性囊肿的首选治疗方法。
