Palanivelu Chinnusamy, Senthilkumar Karuppuswamy, Madhankumar Madathupalayam Velusamy, Rajan Pidigu Seshiyar, Shetty Alangar Roshan, Jani Kalpesh, Rangarajan Muthukumaran, Maheshkumaar Gobi Shanmugam
GEM Hospital, 45-A, Pankaja Mill Road, Ramnathapuram, Coimbatore, 641045, India.
Surg Endosc. 2007 Dec;21(12):2262-7. doi: 10.1007/s00464-007-9365-y. Epub 2007 May 22.
In the era of minimally invasive surgery, laparoscopy has a great role to play in the management of pseudocyst of pancreas. We present our surgical experience over the past 12 years (May 1994 to April 2006) in the management of pancreatic pseudocysts.
The total number of cases was 108, with 76 male and 32 female patients. Age ranged from 18 to 70 years. Duration of symptoms ranged from 45 days to 7 months. Fifty-nine patients presented with pain abdomen. Sixty-one patients had co-morbid illness. Ten patients had abdominal mass on clinical examination. Predisposing factors were gallstones in 58 cases, alcohol in 20 cases, trauma in eight cases and post-pancreatectomy in one case. In 21 cases there are no predisposing factors.
All the cases were successfully operated without any significant intraoperative complication. Laparoscopic cystogastrostomy was done in 90 cases (83.4%), laparoscopic cystojejunostomy in eight cases (7.4%), open cystogastrostomy in two cases (1.8%), and laparoscopic external drainage in eight cases (7.4%). Laparoscopic cholecystectomy was done in 47 cases along with the drainage procedure. The mean operating time was 95 minutes. Mean blood loss was 69 ml. Mean hospital stay was 5.6 days. Percutaneous tube drain to assist decompression of the cyst was kept in all the laparoscopic cystojejunostomy (LCJ) group. Two patients were re-operated for bleeding and gastric outlet obstruction. We had no mortality in the postoperative period. With mean follow up of 54 months (range 3-145 months); only one patient who underwent laparoscopic cystogastrostomy (LCG) earlier in this series had recurrence due to inadequate stoma size. This patient later underwent OCG CONCLUSION: Laparoscopy has a significant role to play in the surgical management of pseudocysts with excellent outcome. It offers all the benefits of minimally invasive surgery to the patients.
在微创手术时代，腹腔镜检查在胰腺假性囊肿的治疗中发挥着重要作用。我们介绍过去12年（1994年5月至2006年4月）我们在胰腺假性囊肿治疗方面的手术经验。
病例总数为108例，其中男性76例，女性32例。年龄范围为18至70岁。症状持续时间为45天至7个月。59例患者表现为腹痛。61例患者有合并症。10例患者临床检查发现腹部肿块。诱发因素包括胆结石58例、酒精20例、外伤8例、胰腺切除术后1例。21例无诱发因素。
所有病例均成功手术，术中无任何重大并发症。90例（83.4%）行腹腔镜囊肿胃吻合术，8例（7.4%）行腹腔镜囊肿空肠吻合术，2例（1.8%）行开放囊肿胃吻合术，8例（7.4%）行腹腔镜外引流术。47例患者在进行引流手术的同时行腹腔镜胆囊切除术。平均手术时间为95分钟。平均失血量为69毫升。平均住院时间为5.6天。所有腹腔镜囊肿空肠吻合术（LCJ）组均留置经皮引流管以辅助囊肿减压。2例患者因出血和胃出口梗阻再次手术。术后无死亡病例。平均随访54个月（范围3至145个月）；本系列中早期行腹腔镜囊肿胃吻合术（LCG）的仅1例患者因吻合口尺寸不足而复发。该患者后来接受了开放囊肿胃吻合术。结论：腹腔镜检查在假性囊肿的手术治疗中发挥着重要作用，效果良好。它为患者提供了微创手术的所有益处。
