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Laparoscopic versus open cystgastrostomy for pancreatic pseudocysts: a case‐matched comparative study 下载免费PDF全文
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腹腔镜外科手术治疗胰腺假性囊肿 总被引:6,自引:1,他引:6
目的:探讨腹腔镜治疗胰腺假性囊肿的临床意义、适应证及方法。方法:2001年12月~2002年8月。2例病人接受了腹腔镜胰腺假性囊肿手术,其中l例行腹腔镜胰腺假行囊肿切除术,另l例行腹腔镜囊肿胃吻合术。结果:2例手术均顺利完成,手术时间120-135min,出血50-60ml,术后24h胃肠功能恢复,无并发症发生,术后7d出院。结论:腹腔镜手术治疗胰腺假性囊肿是一种安全、可靠、微创的新技术,可根据囊肿与周围的粘连程度、基底宽窄及位于胰腺的部位不同而选择囊肿切除或内引流术。 相似文献
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目的探讨小儿胰腺假性囊肿的治疗体会。方法回顾性分析本院1999年1月至2012年12月收治的17例胰腺假性囊肿患儿临床资料,男8例,女9例,年龄2-16岁,平均年龄8.4岁,其中13例行保守治疗;1例行超声引导下经皮穿刺引流;3例手术治疗(1例行囊肿外引流术,1例行囊肿胃吻合术,1例行胰腺囊肿切除术)。结果13例保守治疗病例中,10例治疗有效;3例失败其中1例经皮穿刺引流病例好转出院。3例手术病例均治愈出院。17例中,1例复发,其余治愈及好转病例随访半年至1年均无复发及相关并发症出现。结论胰腺假性囊肿无论大小,大多数经早期保守治疗,可获好转或痊愈;出现手术适应证时应及时手术,手术治愈率高,囊肿吸收快,并发症少。 相似文献
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D'Onofrio M Barbi E Dietrich CF Kitano M Numata K Sofuni A Principe F Gallotti A Zamboni GA Mucelli RP 《European journal of radiology》2012,81(4):630-638
Aim
To describe the typical CEUS pattern of pancreatic lesions and to evaluate the diagnostic accuracy of Contrast-enhanced ultrasound (CEUS) in their characterization.Materials and methods
All US and CEUS examinations of focal pancreatic masses performed in six centers during a period of five years were reviewed. Inclusion criteria were: focal pancreatic mass pathologically proved, visible at ultrasound (US) and studied with CEUS. All lesions were then evaluated for size, aspect and enhancement pattern. Sensitivity, specificity, positive and negative predictive values with 95% CIs were calculated to define diagnostic accuracy of CEUS in respect to pathology. Diagnostic confidence of US and CEUS, discerning between benign and malignant lesions, were represented by using ROC (receiver operating characteristics) curves. Agreement was evaluated by means of k statistics.Results
1439 pancreatic lesions were included. At CEUS the lesions were divided into solid (89%) and cystic (12%) masses and classified into six and eight categories, respectively. Among the solid lesions, adenocarcinomas were characterized with an accuracy of 87.8%. Among the cystic lesions, cystic tumors were diagnosed with an accuracy of 97.1%. ROC curve area increased from 0.637 for US to 0.877 for CEUS (p < 0.0001). Inter-observer agreement was slightly higher for solid (k = 0.78) than cystic (k = 0.62) lesions. In none of the centers side effects were reported.Conclusion
CEUS is accurate in the characterization of pancreatic lesions. CEUS should be considered as a complementary imaging method for pancreatic lesions characterization. 相似文献8.
Pancreatic pseudocysts in children 总被引:2,自引:0,他引:2
Susan M. Sawyer Patricia M. Davidson N. McMullin K. B. Stokes 《Pediatric surgery international》1989,4(5):300-302
Pancreatic pseudocyst (PPC) is an uncommon condition in childhood and is almost always associated with blunt abdominal trauma. Additional disease within the pancreas is rare, unlike adult experience. Prior to the advent of ultrasonography (US) assessment of the cyst was difficult. Subsequently, it has become apparent that PPC may develop but still undergo spontaneous regression. We have reviewed eight children with PPC seen at the Royal Children's Hospital between 1967 and 1987: six males and 2 females ranging in age from 2 to 12 years. The aetiology was blunt abdominal trauma in seven cases and idiopathic pancreatitis in one. Four children presented acutely and the diagnosis of PPC was made by US within 10 days of admission. One of these children had a diagnostic laparotomy for traumatic pancreatitis and his PPC was identified subsequently on serial US. The PPC in this child and one other resolved spontaneously after a period of total parenteral nutrition and intestinal rest. In two cases, the PPC failed to resolve and drainage was necessary. Late presentation (5–16 weeks) after recognised injury occured in four children; all required surgery within 1 week of admission. No surgical complications occured. Conservative management of PPC has been condemned because of the risk of complications occurring during the waiting period. This applies to adults who have developed a PPC in a pancreas diseased due to alcohol and/or cholelithiasis; the natural history of PPC is quite different in children. We thus recommend a trial of conservative treatment for all children who develop a PPC early, but consider that surgery is the best choice for those who present later.
Offprint requests to: P. M. Davidson 相似文献
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目的观察不同方法治疗耳廓假性囊肿的效果。方法对100例门诊耳廓假性囊肿患者随机分为两组,分别采用穿刺抽液加压法、冷冻法治疗:结果穿刺抽液加压法的疼痛、感染、复发率分别为6%、2%、6%,而冷冻法分别为24%、8%、22%(P〈0.05)。结论穿刺加压法较冷冻法效果好、副反应小、复发率低,值得临床推广和应用。 相似文献
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With the advent of new gray scale imaging techniques, ultrasound plays a major role in the diagnosis of pancreatic lesions. As a noninvasive, nonionizing, accurate, and inexpensive diagnostic modality that directly images the pancreatic gland, ultrasound can be used as a primary screening tool. It is helpful in confirming the diagnosis of acute pancreatitis and in detecting and following pseudocysts and other complications. Neoplasms can be detected with a high rate of accuracy, and by assessing the presence of ascites or metastatic foci in the liver, ultrasound can aid in the staging of the neoplastic process. Bowel gas and obesity remain serious limitations to adequate examination, and in these patients computed tomography offers a complementary modality. 相似文献