Al-Shanafey Saud, Shun Albert, Williams Steven
Department of Paediatric Surgery, The Children's Hospital at Westmead, NSW, Sydney, Australia.
J Pediatr Surg. 2004 Jul;39(7):1062-5. doi: 10.1016/j.jpedsurg.2004.03.071.
BACKGROUND/PURPOSE: Symptomatic pancreatic pseudocysts have traditionally been managed with surgical, percutaneous, and, more recently, endoscopic drainage. Although the role of the latter is well defined in the adult population, its utility in children needs to be clarified. The authors reviewed their experience with endoscopic drainage of pancreatic pseudocyst (EDPP).
A retrospective chart review was conducted, and relevant demographic and clinical data were obtained for all patients with pancreatic pseudocysts managed with endoscopic drainage in the period from 1997 through 2001, inclusive.
Three children had successful endoscopic drainage of pancreatic pseudocysts. They were 9, 13, and 14 years old, and were all boys. The etiology of the pancreatitis was idiopathic related to anomalous pancreatic divisum ducts in the first 2 and azathioprine induced in the latter. The first 2 patients had endoscopic transpapillary drainage, whereas the third had an endoscopic cystduodenostomy. All patients had complete resolution of the pseudocyst clinically and radiologically after follow-up periods of 3, 31, and 21 months, respectively. The first needed a subsequent pancreaticojejunostomy for persistent symptoms related to chronic pancreatitis. A successful endoscopic drainage of a posttraumatic pancreatic pseudocyst has previously been reported from our institution.
This experience would indicate that endoscopic drainage of pancreatic pseudocyst is an effective and relatively safe option of managing this problem in children.
背景/目的：有症状的胰腺假性囊肿传统上采用手术、经皮穿刺引流治疗，近来也采用内镜引流治疗。虽然内镜引流在成人中的作用已明确，但在儿童中的效用尚需阐明。作者回顾了他们内镜下引流胰腺假性囊肿（EDPP）的经验。
进行回顾性病历审查，获取了1997年至2001年（含）期间所有接受内镜引流治疗的胰腺假性囊肿患者的相关人口统计学和临床数据。
3名儿童成功接受了胰腺假性囊肿的内镜引流。他们分别为9岁、13岁和14岁，均为男孩。胰腺炎的病因在前2例中为特发性，与胰腺分裂异常导管有关，后1例为硫唑嘌呤诱发。前2例患者接受了内镜下经乳头引流，而第3例接受了内镜下囊肿十二指肠吻合术。所有患者在分别经过3个月、31个月和21个月的随访后，临床和影像学上假性囊肿均完全消退。第1例患者因慢性胰腺炎相关的持续症状随后需要进行胰空肠吻合术。此前，我们机构曾报道过1例创伤后胰腺假性囊肿内镜引流成功的病例。
该经验表明，内镜下引流胰腺假性囊肿是治疗儿童胰腺假性囊肿问题的一种有效且相对安全的选择。
