Arnaud A, Sarles J C, Belkhodja C, Larabi B
Service de Chirurgie générale et digestive, Hôpital Sainte-Marguerite, Marseille.
Chirurgie. 1991;117(8):607-11; discussion 612.
Two new cases of pancreatic hydatidosis are reported. The diagnosis of a cystic lesion of the pancreas has been easily established owing to the modern imaging techniques, especially to computed tomography. The hydatid nature has also been recognized before surgery on the basis of the epidemiological data, the existence of a calcified shell in one case, and positive serology in the other. Retrograde endoscopic cholangiowirsungography allowed specifying the relationships between the cyst and the pancreatic duct in one case. The treatment consisted in the resection of the protruding dome and in total cystectomy. There were no postoperative complications. The preoperative diagnosis of the lesion must no longer be regarded as difficult. The treatment does not raise any specific difficulties when there is no fistula into the pancreatic duct. Retrograde endoscopic cholangiowirsungography is a good means of recognizing a possible fistula and makes a scheduled surgical treatment possible.
报告了两例新的胰腺包虫病病例。由于现代成像技术,尤其是计算机断层扫描,胰腺囊性病变的诊断很容易确立。根据流行病学数据、一例存在钙化壳以及另一例血清学呈阳性,在手术前也已识别出包虫的性质。逆行内镜胆管胰管造影术在一例中明确了囊肿与胰管之间的关系。治疗包括切除突出的囊肿顶部和进行全囊肿切除术。术后无并发症。该病变的术前诊断不应再被视为困难。当不存在胰管瘘时,治疗不会带来任何特殊困难。逆行内镜胆管胰管造影术是识别可能瘘管的好方法,并使有计划的手术治疗成为可能。