Giovannini M, Bernardini D, Seitz J F
Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France.
Gastrointest Endosc. 1998 Aug;48(2):200-3. doi: 10.1016/s0016-5107(98)70165-8.
There are increasing reports of endoscopic drainage of pancreatic pseudocysts. Endoscopic ultrasound (EUS) has been recommended for optimal localization of the puncture site and to reduce the risk of bleeding and perforation. We describe our experience with cystogastrostomy guided entirely by EUS.
EUS-guided cystogastrostomy was performed in six patients. No patient had an endoscopically visible bulge on the gastric wall; gastric varices were evident in one patient. Mean pseudocyst diameter was 4.5 cm (pancreatic body 2, tail 4).
Pseudocyst puncture was successful on one pass in five patients; a nasocystic drain was placed in five, a stent in one. Mean follow-up was 8 months; the pseudocyst reoccurred in only one patient in whom the stent had clogged. There were no complications.
EUS-guided drainage of pseudocysts is accurate and can be performed even if the cyst does not produce an endoscopically visible bulge. It may reduce the risk of complications.
胰腺假性囊肿内镜引流的报道日益增多。内镜超声（EUS）已被推荐用于穿刺部位的最佳定位，以降低出血和穿孔风险。我们描述了完全由EUS引导的囊肿胃造口术的经验。
对6例患者实施了EUS引导下的囊肿胃造口术。没有患者胃壁有内镜可见的隆起；1例患者有明显的胃静脉曲张。假性囊肿平均直径为4.5 cm（胰体部2例，胰尾部4例）。
5例患者一次穿刺成功；5例放置了鼻囊肿引流管，1例放置了支架。平均随访8个月；仅1例支架堵塞的患者假性囊肿复发。无并发症发生。
EUS引导下假性囊肿引流准确，即使囊肿未产生内镜可见的隆起也可进行。它可能降低并发症风险。
