Safioleas Michael C, Moulakakis Konstantinos G, Manti Christina, Kostakis Alkiviadis
2nd Propedeutic Surgical Department, University of Athens, Laiko Hospital, Athens, Greece.
Pancreatology. 2005;5(4-5):457-61. doi: 10.1159/000086548. Epub 2005 Jun 28.
The pancreas is a rare primary location of hydatid disease. The purpose of our study is to gain more insight into this entity and to focus on the management and the diagnostic approach to the disease.
The medical records of 5 patients with hydatid cysts of the pancreas were reviewed.
Four of the cysts were primary, while in 1 case a coexisting cyst was found in the liver. The body and tail of the pancreas were the most common locations. Clinical presentation varied according to the anatomic location of the cyst. Abdominal pain, discomfort and vomiting were the main clinical symptoms. One patient presented with obstructive jaundice, while another patient manifested a mild episode of anaphylactic shock. The indirect hemagglutination test was positive in 3 of 4 cases. A computed tomography scan successfully imaged all cysts and calcification of the cystic wall was found in 3 of 4 cases. All patients underwent surgical therapy. Hydatid cysts in the tail of the pancreas were successfully treated with distal pancreatectomy, while cysts in the body and head of pancreas were treated with proper evacuation, pericystectomy and omentoplasty. The postoperative course was uneventful in all patients except 1 who presented a pancreatic fistula and was re-operated. The mean length of hospitalization after surgery was 11-12 (range 10-13) days, except for the patient who needed to be re-operated. No evidence of cyst recurrence was observed during the follow-up period.
Hydatid cystic masses of the upper abdomen might also originate from the pancreas especially in endemic countries. Surgical excision of the entire cystic lesion remains the optimal treatment, offering hope for a complete cure.
胰腺是包虫病罕见的原发部位。我们研究的目的是更深入地了解这一疾病，并关注其治疗和诊断方法。
回顾了5例胰腺包虫囊肿患者的病历。
4例囊肿为原发性，1例患者肝脏中发现并存囊肿。胰腺体尾部是最常见的部位。临床表现因囊肿的解剖位置而异。腹痛、不适和呕吐是主要临床症状。1例患者出现梗阻性黄疸，另1例患者表现为轻度过敏反应性休克。4例中有3例间接血凝试验呈阳性。计算机断层扫描成功显示了所有囊肿，4例中有3例发现囊壁钙化。所有患者均接受了手术治疗。胰腺尾部的包虫囊肿通过胰腺远端切除术成功治疗，而胰腺体部和头部的囊肿则通过适当的囊肿排空、囊肿切除术和网膜成形术进行治疗。除1例出现胰瘘并再次手术的患者外，所有患者术后病程均顺利。除需要再次手术的患者外，术后平均住院时间为11 - 12天（范围10 - 13天）。随访期间未观察到囊肿复发迹象。
上腹部的包虫囊肿肿块也可能起源于胰腺，尤其是在流行地区。完整切除整个囊性病变仍然是最佳治疗方法，有望实现完全治愈。
