摘要
重新认识胰腺炎后胰腺假性囊肿的外科处理,探讨内引流术治疗囊肿伴感染及坏死的可能性。方法:回顾性分析1988年～1996年我科收治的25例胰腺炎后胰腺假性囊肿患者。结果:手术治疗的22例中,对6例高度怀疑感染的囊液作了细菌培养,证实2例继发感染。18例行内引流,包括4例囊液呈脓样者(其中1例细菌培养阳性),均无并发症,随访1～9年无复发。外引流仅3例(12.0％),明显低于国内文献报道的平均值21.7％(P<0.05)。结论:根据囊肿内容物性状来判断是否继发感染并不准确,既使存在感染,在囊壁成熟的前提下应尽量行内引流,术后并无不良后果。而外引流由于其诸多弊端,应慎重选用。
To reappraise the surgical management of postpancreatitic pancreatic pseudocyst and to probe the possibility of treating infected or necrotic pseudocyst with internal drainage. Methods: We ana-lyzed retrospectively the 25 cases of pancreatic pseudocyst due to pancreatitis admitted from 1988 to 1996. Results: Of the 22 operated cases, 6 specimens of cyst liquid suspected of being infected were cultured for bacteria, only 2 cases were proved to be positive. Internal drainage was performed in 18 cases, of which 4 were thought to be infected with 1 positive culture. All of them were exempted from complications after the operation. No recurrence was noted in a 1 to 9 years follow-up. External drainage was performed in 3 cases only(12.0%), significantly less than the average figure(21.7%) reported in the Chinese literature(P< 0.05). Conclusions: It is not reliable to judge whether infection exists by the appearance of the pseudocyst content. Even if infection exists, it is possible to perform internal drainage, in cases with a matured cyst wall. External drainage should be performed only occasionally because of its well-known shortcomings.
出处
《外科理论与实践》
1999年第1期43-45,共3页
Journal of Surgery Concepts & Practice
关键词
胰腺假性囊肿
胰腺炎
外科手术
Pancreatic pseudocyst Surgical management Pancreatitis
