摘要
目的:探讨交通性胰腺假性囊肿的逆行胰胆管造影(ERCP)特征及内镜治疗效果.方法:回顾分析42例ERCP显影的胰腺假性囊肿病例资料,其中慢性胰腺炎38例,急性胰腺炎3例,外伤性1例.结果:发现囊肿共44个,41个呈椭圆形,3个为不规则形.胰头部20个,胰体部8个,胰尾部16个;平均大小(cm×cm)分别为4.1×3.0、3.7×2.7、3.9×2.4,囊肿前胰管径均值分别为0.18、0.20、0.23 cm.囊肿后胰管显影率16.7%(7/42).胰尾胰管扩张者占62.5%(10/16).13例胰管支架治疗,囊肿消退,腹痛、胃纳、脂肪泻及体质量明显改善9例(69.2%),2例(15.4%)改善不明显,2例(15.4%)无效者转手术治疗;随访2～36个月,1例(7.7%)囊肿复发但无症状,只有1例支架术后出现高淀粉酶血症.5例鼻胰管过渡性引流治疗.手术治疗11例(含支架治疗失败者2例,鼻胰管过渡性引流2例).内科治疗及被观察者18例.结论:交通性胰腺假性囊肿多为椭圆形,囊肿相对较小,囊肿前胰管径大多狭窄.内镜治疗安全有效,可作为首选,其次考虑手术及内科治疗.
Objective:To explore imaging characteristics and the terapeutic effectiveness of endoscopic retrograde cholan-giopancreatography (ERCP) in diagnosing and treating pancreatic pseudocysts communicated with the pancreatic ductal system. Methods;Data of 42 patients diagnosed and treated with ERCP were analyzed retrospectively. The etiologies of the pancreatic pseudocysts included chronic pancreatitis in 38 patients, acute pancreatitis in 3 patients, and trauma in 1 patient. Results:A total of 44 pancreatic pseudocysts were found by ERCP. There were 20 cases in the head of the pancreas, 8 cases in the body and 16 in the tail mean sizes being 4. 1 cm×3. 0 cm,3. 7 cm×2. 7 cm, and 3. 9 cm×2. 4 cm respectively. Of the 13 patients undergoing ERCP pancreatic stent insertion, 9(69. 9%) achieved complete resolution of the symptoms, 2 had incomplete resolution, and 2 had no improvement and were submitted to surgery. Eleven patients received surgical treatment and 18 received internal medical treatment. Conclusion:ERCP management is an effective alternative to conventional surgical treatment of pancreatic pseudocysts communicated with the pancreatic ductal system.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2004年第5期566-568,共3页
Academic Journal of Second Military Medical University
关键词
内镜治疗
胰腺假性囊肿
逆行胰胆管造影
诊断
pancreatic pseudocysts
endoscopic retrograde cholangiopancreatography
diagnosis
therapy
