Vasilescu Alin, Tarcoveanu Eugen, Crumpei Felicia, Blaj Mihaela, Bejan Valentin, Bradea Costel
Chirurgia (Bucur). 2020 Mar-Apr;115(2):261-266. doi: 10.21614/chirurgia.115.2.261.
The pancreatic localization of the hydatid cyst is exceptional, even in countries where hydatid disease is considered endemic. We describe a female patient, 63 years old, with hydatid cyst of the pancreas. The diagnosis was difficult because the presentation was that of an epigastric cyst of unknown origin, with no suggestive radiological and ultrasonography features. We performed a laparoscopic exploration of abdominal cavity which revealed a retrogastric cystic mass developed from the pancreatic body. The surgical treatment consisted in puncture, evacuation of proligera, lavage with hypertonic serum, partial excision of the pericyst and drainage of the cavity. The postoperative course was uneventfull and the patient was released after 5 days. The follow-up at 6, 12 and 24 month did not show relapse. Through this observation and a review of the literature, we discuss the diagnostic and therapeutic difficulties of this rare localization of the hydatid cyst. Hydatid cyst is a rare cause of a cystic lesion of the pancreas, especially in endemic areas. Surgery still remains the most effective treatment option. Laparoscopic approach is feasible and secure but requires a trained team with experience in minimally invasive surgery.
即使在被认为是包虫病流行的国家，胰腺包虫囊肿的定位也很罕见。我们描述了一名63岁的女性患者，患有胰腺包虫囊肿。诊断很困难，因为其表现为来源不明的上腹部囊肿，没有提示性的放射学和超声特征。我们对腹腔进行了腹腔镜探查，发现一个源于胰体的胃后囊性肿块。手术治疗包括穿刺、排出原头节、用高渗血清冲洗、部分切除包囊周围组织并引流囊腔。术后过程顺利，患者在5天后出院。6个月、12个月和24个月的随访均未显示复发。通过该病例观察及文献复习，我们讨论了这种罕见的胰腺包虫囊肿定位的诊断和治疗难点。包虫囊肿是胰腺囊性病变的罕见病因，尤其是在流行地区。手术仍然是最有效的治疗选择。腹腔镜手术方法可行且安全，但需要一支在微创手术方面有经验的专业团队。
