Elechi E N, Callender C O, Leffall L D, Kurtz L H
Surg Gynecol Obstet. 1979 May;148(5):707-10.
Twenty-two patients were treated for 25 occurrences of pancreatic pseudocysts. The male to female ratio was 3:1, and the average age was 39 years. Alcoholism was the most common cause of the preceding episode of pancreatitis. The pseudocyst rarely developed from end-stage chronic pancreatitis. Our preferred treatment for the majority of pancreatic pseudocysts is external sump drainage, if there is no obstruction of the distal part of the pancreatic duct. This form of treatment was followed by a 100 per cent survival rate, and neither a pancreaticocutaneous fistula nor a pancreatic abscess occurred. The two instances of a recurrence were due to our treatment with a Penrose drain alone, and this practice is not recommended. Obstruction of the distal part of the pancreatic duct negates external sump drainage, and in such instances, a Roux-en-Y cystojejunostomy should be the treatment of choice and not transgastric cystogastrostomy, which does not offer dependent drainage. The treatment of a pancreatic pseudocyst should not be equated with that of chronic fibrotic pancreatitis, as the basic pathologic clinical features and response to surgical treatment are quite different.
22例患者因25处胰腺假性囊肿接受治疗。男女比例为3:1，平均年龄为39岁。酗酒是胰腺炎前次发作最常见的原因。假性囊肿很少由终末期慢性胰腺炎发展而来。如果胰管远端无梗阻，我们对大多数胰腺假性囊肿的首选治疗方法是外引流。这种治疗方式的生存率为100%，且未发生胰皮肤瘘或胰腺脓肿。两例复发是由于我们仅使用了彭罗斯引流管进行治疗，这种做法不推荐。胰管远端梗阻使外引流无法进行，在这种情况下，应选择 Roux-en-Y 囊肿空肠吻合术而非经胃囊肿胃造口术，因为经胃囊肿胃造口术无法提供依赖引流。胰腺假性囊肿的治疗不应等同于慢性纤维化胰腺炎的治疗，因为其基本病理临床特征和对手术治疗的反应有很大不同。
