Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Pancreas. 2012 May;41(4):577-81. doi: 10.1097/MPA.0b013e3182374def.
The aim of this study was to analyze the incidence, risk factors, and clinical outcomes of pancreatic pseudocyst after acute or acute-on-chronic pancreatitis.
We retrospectively reviewed the medical records of 350 patients with acute pancreatitis and 55 patients with acute-on-chronic pancreatitis.
Pancreatic pseudocyst developed in 14.6% of acute pancreatitis and in 41.8% of acute-on-chronic pancreatitis (P = 0.00). In the acute-on-chronic pancreatitis group, interval from symptom onset to hospital visit was longer, and the incidence of recurrent pancreatitis and alcoholic etiology was higher than that of the acute pancreatitis group (P < 0.01). There was no significant difference in the spontaneous resolution rate between both groups. Of the total 68 conservatively treated patients with pseudocyst, the pseudocyst decreased in size or disappeared in 77.9% and showed no change in 1.5%. The risk factors of pseudocyst were the presence of underlying chronic pancreatitis, the interval from symptom onset to visiting the hospital, and an alcoholic etiology. The factor-predicted spontaneous resolution was a single lesion.
Pseudocyst developed more frequently in patients with acute-on-chronic pancreatitis, and most pseudocysts improved spontaneously irrespective of underlying chronic pancreatitis. A longer period of a "wait-and-see" policy for more than 6 weeks is suggested for asymptomatic pseudocyst, especially for a single lesion.
本研究旨在分析急性胰腺炎和亚急性慢性胰腺炎后胰腺假性囊肿的发生率、危险因素和临床转归。
我们回顾性分析了 350 例急性胰腺炎和 55 例亚急性慢性胰腺炎患者的病历。
急性胰腺炎患者中胰腺假性囊肿的发生率为 14.6%，亚急性慢性胰腺炎患者中为 41.8%（P = 0.00）。在亚急性慢性胰腺炎组中，从症状发作到就诊的时间间隔较长，复发性胰腺炎和酒精性病因的发生率高于急性胰腺炎组（P < 0.01）。两组自发缓解率无显著差异。在 68 例接受保守治疗的假性囊肿患者中，77.9%的假性囊肿体积缩小或消失，1.5%无变化。假性囊肿的危险因素包括存在基础慢性胰腺炎、从症状发作到就诊的时间间隔和酒精性病因。预测假性囊肿自发缓解的因素是单个病变。
亚急性慢性胰腺炎患者胰腺假性囊肿的发生率较高，大多数假性囊肿无论是否存在基础慢性胰腺炎均可自发缓解。对于无症状的假性囊肿，特别是单个病变，建议采取超过 6 周的“静观其变”策略。
