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[胰腺非典型性胰腺外假性囊肿]

[Atypical, extra pancreatic pseudocyst of the pancreas].

作者信息

Havlůj L, Mlýnek B, Gürlich R

出版信息

Rozhl Chir. 2016 Mar;95(3):126-30.

Abstract

UNLABELLED

The pseudocyst of the pancreas is one of the most common cystic lesions of the pancreas. The pseudocysts can be defined as intrapancreatic, peripancreatic or extrapancreatic fluid collections with a defined wall formed mostly on the basis of acute or chronic pancreatitis. This is a relatively common complication of acute or chronic pancreatitis. Sonography is essential for the diagnosis given its noninvasivity and availability. Other assessments that show the highest accuracy, specificity and sensitivity include MDCT and ERCP. The MDCT and ERCP assessments can be used to classify the pseudocyst; the treatment algorithm is then determined based on this classification. MDCT should ideally be preceded by ERCP. EUS-FNAB or aspiration with the determination of oncomarkers and AMS in the aspirate have been shown to be most important to distinguish the pseudocyst from malignant cystic lesions. Functional classification of the pseudocyst is an important prerequisite for successful algorithm of the treatment. The classification is based mainly upon anatomical relations of the pseudocyst to the pancreatic outlet and morphology of the pancreatic parenchyma. Percutaneous drainage, endoscopic and surgical methods are mainly applied in the treatment. The authors present a case report of a very rare extrapancreatic pseudocyst.

KEY WORDS

pseudocyst pancreatic pseudocyst classification extrapancreatic pseudocyst.

摘要

未标注

胰腺假性囊肿是胰腺最常见的囊性病变之一。假性囊肿可定义为胰腺内、胰腺周围或胰腺外的液体积聚,其具有主要基于急性或慢性胰腺炎形成的明确壁层。这是急性或慢性胰腺炎相对常见的并发症。鉴于超声检查的非侵入性和可及性,它对诊断至关重要。其他显示出最高准确性、特异性和敏感性的评估包括多层螺旋CT(MDCT)和内镜逆行胰胆管造影(ERCP)。MDCT和ERCP评估可用于对假性囊肿进行分类;然后根据该分类确定治疗方案。理想情况下,MDCT应在ERCP之前进行。内镜超声引导下细针穿刺抽吸活检(EUS-FNAB)或抽吸并测定抽吸物中的肿瘤标志物和淀粉酶已被证明对于区分假性囊肿与恶性囊性病变最为重要。假性囊肿的功能分类是成功制定治疗方案的重要前提。该分类主要基于假性囊肿与胰腺出口的解剖关系以及胰腺实质的形态。经皮引流、内镜和手术方法主要应用于治疗。作者报告了一例非常罕见的胰腺外假性囊肿病例。

关键词

假性囊肿;胰腺假性囊肿;分类;胰腺外假性囊肿

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