Segal I
Gastroenterology Division, Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Gastroenterologist. 1993 Mar;1(1):34-8.
Surgery has been the cornerstone of treatment for pancreatic pseudocysts. This was based on studies that delineated the natural history and showed high morbidity and mortality rates if surgery was not performed. Recently this view has been challenged. Observations using new imaging techniques indicate that pseudocysts may resolve over time and surgery may not be necessary. An additional advantage of modern imaging and technical expertise is that pseudocysts can be successfully drained percutaneously. Also, the ingenuity of interventional endoscopists has led to another form of therapy--endoscopic cystoenterostomy, which is now part of the therapeutic armamentarium. With regard to drug therapy, octreotide acetate has emerged as an important adjunct to the treatment of fistulas complicating percutaneous catheter drainage. Moreover, it has been used as a primary treatment of pseudocysts. The nonsurgical types of treatment provide alternatives to surgery in some patients with pancreatic pseudocysts. However, these modalities should be viewed as complementary rather than conflicting alternatives and should be used selectively on the basis of clinical and radiological observations. This review discusses the major methods of nonsurgical therapy.
手术一直是胰腺假性囊肿治疗的基石。这是基于一些研究，这些研究描绘了其自然病程，并表明如果不进行手术，发病率和死亡率会很高。最近，这种观点受到了挑战。使用新成像技术的观察表明，假性囊肿可能会随时间自行消退，可能无需手术。现代成像和技术专长的另一个优势是假性囊肿可以通过经皮穿刺成功引流。此外，介入内镜医师的独创性带来了另一种治疗形式——内镜下囊肿肠吻合术，它现在是治疗手段的一部分。关于药物治疗，醋酸奥曲肽已成为治疗经皮导管引流并发瘘管的重要辅助药物。此外，它还被用作假性囊肿的主要治疗方法。非手术治疗类型为一些胰腺假性囊肿患者提供了手术之外的选择。然而，这些治疗方式应被视为互补而非相互冲突的选择，应根据临床和影像学观察结果有选择地使用。本综述讨论了非手术治疗的主要方法。
