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[胰腺假性囊肿治疗中的外科手术方面]

[Surgical aspect in the management of pancreatic pseudocyst].

作者信息

Gómez N A

出版信息

Acta Gastroenterol Latinoam. 1985;15(2):103-12.

PMID:3915171
Abstract

During the years from 1969 to 1979, 35 patients were operated 36 occasioned by pancreatic pseudocysts in the Department of Surgery of the University Hospital of Göettingen, West Germany. They were utilized as diagnostic methods laboratory exams, especially serial seric and urinary amylase as creatinine and at the same time abdominal echography, upper gastrointestinal tract X-rays, thorax X-rays, Barium Enema and Biliary tract X-rays. Although the great number of transit accidents, the traumatic pancreatic pseudocysts were seldom found and most of them were operated as a result of a chronic pancreatitis. Contrarily the pancreatic pseudocysts as result of an acute pancreatitis and recurrent acute pancreatitis were in a limited number. We observed only 2 cases of acute pancreatitis with biliary etiology. We realized one operation in 31 cases and in one resection, four of the series, was the only occasion that we recurred for a second and a third operation. The external drainage was realized exclusively in 3 cases while internal drainage was performed 28 times. The surgical technic frequently used as internal drainage was the Roux en-Y Cystojejunostomy and was perfomed in 21 patients. This method demonstrated to be the most fit by morphologic as functional reasons. We observed that our mortality was null and our post-operative morbility was minimal, so, we have only 3 patients with complicated post-operative course. The mean hospitalization time was 25 days. We surgical treatment of choice for the drainage of the pancreatic pseudocysts.

摘要

在1969年至1979年期间,德国哥廷根大学医院外科有35例患者因胰腺假性囊肿接受了36次手术。采用了实验室检查作为诊断方法,特别是连续检测血清和尿液淀粉酶与肌酐,同时进行腹部超声检查、上消化道X线检查、胸部X线检查、钡灌肠和胆道X线检查。尽管交通事故数量众多,但创伤性胰腺假性囊肿很少见,大多数是由于慢性胰腺炎而进行手术。相反,急性胰腺炎和复发性急性胰腺炎导致的胰腺假性囊肿数量有限。我们仅观察到2例胆源性急性胰腺炎。我们对31例患者进行了一次手术,在一个系列中的4例切除手术中,只有这一次进行了第二次和第三次手术。仅3例进行了外引流,而内引流进行了28次。最常使用的内引流手术技术是Roux-en-Y囊肿空肠吻合术,21例患者采用了该方法。从形态学和功能方面来看,这种方法被证明是最合适的。我们观察到死亡率为零,术后发病率极低,因此,只有3例患者术后病程复杂。平均住院时间为25天。我们认为手术治疗是胰腺假性囊肿引流的首选方法。

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