Sekioka Akinori, Takahashi Toshiaki, Fukumoto Koji, Urushihara Naoto
Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Shizuoka Prefecture, Japan.
Department of Pediatric Surgery, Shizuoka Children's Hospital, Aoi-ku, Shizuoka, Japan.
Afr J Paediatr Surg. 2018 Jul-Dec;15(3):148-150. doi: 10.4103/ajps.AJPS_71_17.
Pancreatic pseudocysts (PPs) often occur in association with acute pancreatitis or pancreatic trauma and are uncommon disorders in children. PPs require operative interventions in case they do not disappear spontaneously. There are several interventional treatments, and laparoscopic or endoscopic treatments have been recently reported as a less invasive procedure. However, these procedures are sometimes difficult to perform for small children. We describe a novel intragastric cystogastrostomy with mini-laparotomy for a 4-year-old female child. She presented with a PP caused by trauma. The PP failed to resolve after 6 weeks and we performed open cystogastrostomy. We made mini-laparotomy and inserted a wound retractor into the stomach and expanded both the abdominal and the gastric walls. This procedure created a good operative field and enabled intragastric cystogastrostomy even in small children. There were no complications. At 10-month postsurgery, a follow-up computed tomography showed no recurrence of PP. This novel intragastric cystogastrostomy for PP, which includes the insertion of a wound retractor, is a safe, minimally invasive, and technically feasible approach for younger children with PP. To the best of our knowledge, this is the first report to describe the intragastric cystogastrostomy with a wound retractor.
胰腺假性囊肿（PPs）常与急性胰腺炎或胰腺创伤相关，在儿童中是罕见疾病。如果PPs不能自发消失，则需要进行手术干预。有几种介入治疗方法，最近有报道称腹腔镜或内镜治疗是一种侵入性较小的手术。然而，对于幼儿来说，这些手术有时很难实施。我们描述了一种用于一名4岁女童的新型经胃囊肿胃造口术，采用小切口剖腹术。她因外伤出现PPs。6周后PPs未消退，我们进行了开放性囊肿胃造口术。我们做了小切口剖腹术，将伤口牵开器插入胃内，扩张腹壁和胃壁。该手术创造了良好的手术视野，即使在幼儿中也能进行经胃囊肿胃造口术。无并发症发生。术后10个月，随访计算机断层扫描显示PPs无复发。这种用于PPs的新型经胃囊肿胃造口术，包括插入伤口牵开器，对于患有PPs的幼儿来说是一种安全、微创且技术上可行的方法。据我们所知，这是第一份描述带有伤口牵开器的经胃囊肿胃造口术的报告。
