Sharma Shyam Sunder, Maharshi Sudhir
Department of Gastroenterology, SMS Medical College, Jaipur 302021, India.
J Pediatr Surg. 2008 Sep;43(9):1636-9. doi: 10.1016/j.jpedsurg.2008.01.026.
Literature on long-term outcome after endoscopic management of pediatric pancreatic pseudocyst is not available. The aim of the present study is to report long-term outcome after endoscopic drainage of pancreatic pseudocyst in children.
Nine patients younger than 15 years, subjected to endoscopic pseudocyst drainage, were included in this study (between 1994 and 2004). Eight patients were subjected to endoscopic cystogastrostomy and stenting, whereas 1 patient was subjected to cystoduodenostomy and stenting. A follow-up of patients was done at 1 month and at 2 to 10 years after drainage. Endoscopic retrograde cholangiopancreatography (ERCP) was done in 2 patients at the time of drainage, and it was repeated in both the patients at the time of final follow-up.
Mean age of the patients was 9.6 years. Trauma was the most common cause (n = 8). Mean follow-up of these patients was 5.7 years (2-10 years). No recurrence was seen in any patient. Endoscopic retrograde cholangiopancreatography revealed complete pancreatic duct block in prevertebral region in 2 posttraumatic patients, and it was persisting on repeat ERCP at final follow-up.
Endoscopic drainage of pancreatic pseudocyst is safe in children with a very good long-term outcome. Pancreatic duct block seen on ERCP may not be clinically important on long-term follow-up.
目前尚无关于小儿胰腺假性囊肿内镜治疗后长期预后的文献。本研究的目的是报告儿童胰腺假性囊肿内镜引流后的长期预后。
本研究纳入了9例15岁以下接受内镜下假性囊肿引流的患者（1994年至2004年期间）。8例患者接受了内镜下囊肿胃吻合术和支架置入术，1例患者接受了囊肿十二指肠吻合术和支架置入术。在引流后1个月以及2至10年对患者进行随访。2例患者在引流时进行了内镜逆行胰胆管造影（ERCP），并在末次随访时对这2例患者再次进行了ERCP。
患者的平均年龄为9.6岁。外伤是最常见的病因（n = 8）。这些患者的平均随访时间为5.7年（2至10年）。所有患者均未复发。内镜逆行胰胆管造影显示，2例创伤后患者的椎体前区域胰管完全阻塞，且在末次随访时重复ERCP检查时仍持续存在。
儿童胰腺假性囊肿内镜引流是安全的，长期预后良好。ERCP显示的胰管阻塞在长期随访中可能无临床意义。
