Bradley E L, Clements J L, Gonzalez A C
Am J Surg. 1979 Jan;137(1):135-41. doi: 10.1016/0002-9610(79)90024-2.
Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven of the ninety-three patients. Another twenty-eight patients underwent elective drainage of the pseudocyst. The remaining fifty-four constituted the study group and were followed with serial clinical and sonographic examinations until either spontaneous resolution occurred, complications developed, or the patients did not return. Complications arising during the period of observation in the untreated patients (rupture, abscess, jaundice, and hemorrhage) occurred more than twice as commonly as spontaneous resolution (41 per cent versus 20 per cent), and led directly to death in seven cases (14 per cent). No deaths occurred in the group of patients undergoing elective surgical drainage (p less than 0.05). The interval between presumed formation of the pseudocyst and the development of a complication averaged 13.5 +/- 6 weeks. Prolonged observation of pancreatic pseudocysts in the expectation of spontaneous resolution exposed the patient to an unwarranted risk, which, after seven weeks, greatly exceeded the mortality of elective surgery.
1971年至1976年间，在923例因胰腺疾病入院的患者中，经超声检查确诊为假性囊肿的患者有93例。诊断的不确定性和/或潜在胰腺炎的快速进展导致93例患者中有11例紧急剖腹手术并引流。另外28例患者接受了假性囊肿的择期引流。其余54例构成研究组，通过系列临床和超声检查进行随访，直至囊肿自行消退、出现并发症或患者未再复诊。未经治疗的患者在观察期间出现的并发症（破裂、脓肿、黄疸和出血）的发生率是自行消退发生率的两倍多（41%对20%），并直接导致7例患者死亡（14%）。接受择期手术引流的患者中无死亡病例（P<0.05）。假性囊肿形成至并发症出现的平均间隔时间为13.5±6周。期望囊肿自行消退而对胰腺假性囊肿进行长时间观察会使患者面临不必要的风险，7周后，这种风险大大超过了择期手术的死亡率。
