Gaikwad Vivek Samuel, Kisku Sundeep M C, Kurian Jujju Jacob, Jacob Tarun John K, Mathai John
Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
J Indian Assoc Pediatr Surg. 2022 Jan-Feb;27(1):77-82. doi: 10.4103/jiaps.JIAPS_331_20. Epub 2022 Jan 11.
Pancreatic pseudocysts (PPCs) and walled-off necrosis (WON) in children following acute pancreatitis are uncommon. The various modalities of therapy possible are conservative treatment, external drainage, endoscopic stenting, and internal surgical drainage procedures. There are no existing guidelines for the management of PPC in children. We evaluate the outcomes of laparoscopic cystogastrostomy (LCG) performed at our center.
Eight children (median age: 10 years) underwent LCG for large PPC (median size: 12.5 cm). There were seven patients with PPC and one with WON. Seven underwent LCG by a transgastric approach and one underwent LCG by a retrogastric approach.
Seven out of the eight patients had complete resolution of symptoms and the PPC. The median follow-up period was 32 months (interquartile range: 9.5-55.5 months). There were no conversions. There was one patient with a WON who developed a recurrence.
LCG is a safe and effective treatment option for large PPC/WON in children. A posterior retrogastric approach, when indicated, is a safe approach with a comparable outcome.
儿童急性胰腺炎后胰腺假性囊肿(PPCs)和包裹性坏死(WON)并不常见。可能的治疗方式有保守治疗、外引流、内镜支架置入和内外科引流手术。目前尚无儿童PPC管理的现有指南。我们评估了在我们中心进行的腹腔镜囊肿胃吻合术(LCG)的结果。
8名儿童(中位年龄:10岁)因大型PPC(中位大小:12.5 cm)接受了LCG。其中7例为PPC患者,1例为WON患者。7例通过经胃途径进行LCG,1例通过胃后途径进行LCG。
8例患者中有7例症状和PPC完全缓解。中位随访期为32个月(四分位间距:9.5 - 55.5个月)。无中转开腹情况。有1例WON患者出现复发。
LCG是治疗儿童大型PPC/WON的一种安全有效的选择。必要时采用胃后途径是一种安全的方法,效果相当。