胰腺假性囊肿的外科治疗.doc

胰腺假性囊肿的外科治疗
【摘要】目的探讨胰腺假性囊肿的外科治疗方法。方法回顾性分析46例胰腺假性囊肿患者的临床资料,行胃囊肿内引流术6例,急性囊肿Roux-en-Y内引流术37例,胰体尾切除3例。结果全组无围手术期死亡病例,并发胰瘘2例,经保守治疗痊愈。术后随访5月—5年均恢复良好,疗效满意。结论胰腺假性囊肿的治疗要根据患者的具体情况及手术者的经验和医院的条件,选择合理的治疗方法,外科手术能取得较好的疗效。
【Abstract】 Objective This study is to explore the surgical treatment of pancreatic pseudocyst Methods By retrospective analysis of 46 cases of pancreatic pseudocyst in patients with clinical data, drainage of gastric cyst 6 cases, Acute cyst Roux-en-Y internal drainage 37 cases, pancreatic resection in 3 cases. Results There were no perioperative deaths, pancreatic fistula in 2 cases, cured by conservative treatment. After an average follow-up of 5 months -5 years recovery, the results were satisfactory. Conclusion Patients with pancreatic pseudocyst based on the specific circumstances, the experience of surgery and hospital conditions, by selecting reasonable treatment, surgery can achieve good results.
胰腺假性囊肿是临床常见病,多继发于急、慢性胰腺炎、胰腺手术后或胰腺外伤所致的胰液外渗或胰管断裂所形成的局部包裹性囊肿,亦有少数继发于恶性肿瘤或无明显原因。我科2003-2010年共收治46例胰腺假性囊肿病员,现报告如下;
1 临床资料
一般资料男29例,女17例,年龄20-68岁,,其中40例有胰腺炎病史,4例有胰腺外伤史,另有2例病因不明。病程6月-10年,30例有上腹部胀痛不适,11例有不同程度的发热,5例有恶心、呕吐,5例有上腹部包块,1例无临床症状为体检时发现。所有患者入院后均行胰腺B超和CT检查以明确诊断。囊肿位于胰头部15例,胰体尾31例。囊肿直径均大于6cm。对于囊肿直径<6cm、病程<6周的患者在消化内科行保守治疗或门诊随访。
治疗方法全组患者均经外科治疗,其中胃-囊肿内引流术6例,空肠-囊肿Roux-en-Y吻合内引流术37例,胰体尾切除3例。
2 结果
全组无围手术期死亡病例,并发胰瘘2例,均经保守治疗痊愈,术后46例随访5月-5年,均复查B超或CT,无囊肿复发,