Figueira A, Colleoni Neto R, Jorge Júnior M E, Caetano Júnior E M, Ferraro J R, Trivino T
Disciplina de Gastroenterologia Cirúrgica da Escola Paulista de Medicina, São Paulo.
Rev Assoc Med Bras (1992). 1994 Jul-Sep;40(3):202-6.
Until recently, the treatment of pancreatic pseudocysts was mainly surgical. However, two non-surgical invasive approaches are now possible: percutaneous aspiration under ultrasonic or CT monitoring and endoscopic drainage. PURPOSE--To report the result obtained using endoscopic drainage of pancreatic pseudocysts. METHODS--11 consecutive patients admitted with pancreatic pseudocyst had chronic pancreatitis and 1 patient had a well defined paraduodenal collection originated from acute necrotising pancreatitis. Endoscopic cystoduodenostomy was performed in the area of close contact with the digestive wall. A standard Olympus duodenoscope was used to reach the bulging wall and to allow the diatermic fistula. RESULTS--The success rate was 91.7%. Hemorrhage occurred in 1 patient (8.3%) controlled without blood transfusion. Endoscopic cystoduodenostomy was the definitive treatment in 10 patients 36 months after the procedure. One patient underwent gastrojejunostomy after 14 months for duodenal obstruction following relapsing pancreatitis. There was no relapsing cyst. There was no death following the endoscopic procedure. CONCLUSION--the endoscopic cystoduodenostomy constitutes an alternative procedure for the drainage of paraduodenal pseudocysts whenever restricted to the precise morphological indication of paraintestinal pseudocyst bulging into the duodenal lumen.
直到最近，胰腺假性囊肿的治疗主要还是手术治疗。然而，现在有两种非手术的侵入性方法可行：在超声或CT监测下经皮抽吸和内镜引流。目的——报告使用内镜引流胰腺假性囊肿的结果。方法——连续11例因胰腺假性囊肿入院的患者患有慢性胰腺炎，1例患者有一个明确的起源于急性坏死性胰腺炎的十二指肠旁积液。在内镜下于与消化壁紧密接触的区域进行囊肿十二指肠造口术。使用标准的奥林巴斯十二指肠镜到达膨出壁并形成透热瘘。结果——成功率为91.7%。1例患者（8.3%）发生出血，未输血得以控制。10例患者在术后36个月内镜囊肿十二指肠造口术是确定性治疗。1例患者在14个月后因复发性胰腺炎导致十二指肠梗阻而接受胃空肠吻合术。没有囊肿复发。内镜手术后无死亡病例。结论——只要限于十二指肠旁假性囊肿膨入十二指肠腔的精确形态学指征，内镜囊肿十二指肠造口术就构成十二指肠旁假性囊肿引流的一种替代方法。
