小儿假性胰腺囊肿31例诊治分析

目的 :探讨假性胰腺囊肿的诊断与合理的治疗方法。方法 :对 31例假性胰腺囊肿的诊治进行回顾性分析。结果 :急性假性胰腺囊肿血、尿淀粉酶增高者约 90 % ,慢性假性胰腺囊肿血、尿淀粉酶增高者约 48%。 2 8例行上腹部 B超检查 ,符合诊断 2 4例 ,占 85 %。7例行 CT检查 ,符合诊断 6例 ,占 85 %。急性假性胰腺囊肿 8例 ,保守治愈 4例 ,因并发囊肿破裂、囊内感染行外引流术 3例 ,改行 期内引流 1例均获治愈 ;慢性囊肿 2 3例行囊肿空肠 Roux- en- Y内引流术 4例 ,囊内置管囊肿胃后壁内、外引流术 1 0例 ,对囊肿不超过胃大弯 6例 ,囊肿向横结肠系膜突出的 3例分别实行了我院自行设计的胃后壁小切口囊内置管外引流术及囊肿空肠乳头状吻合术 ,作者认为这两种术式操作简便疗效满意。结论 :B超、CT检查是诊断假性胰腺囊肿的有效方法。该病的治疗应以个体病程长短、囊肿大小、部位、囊壁厚薄、与邻近器官的关系及有无并发症予以选择 ,力求手术简便有效。

Aanalysis of diagnosis and treatment of pancreatic pseudocyst in children (an analysis of 31 cases)

Objective: To investigate the suitable methods for diagnosis and treatment of pancreatic pseudocyst in children. Methods: Diagnosis and treatment of 31 cases of pancreatic pseudocyst were studied restrospectively. Results: Elevation of serum amylase and urine amylase activities were seen in 7 out of 8 cases of acute cyst, and in 11 out of 23 cases of chronic cyst. Ultrasonograph revealed the presence of epigastric cyst in 24 out of 28 cases. Computer tomgraph showed the presence of cyst in 6 out of 7 cases. Among 8 cases of the acute cyst ,4 cases of conservative treatment and 3 cases of cystoperitoneal space drainage were successful .For chronic pseudocyst of pancreas cystojejunoctomy with Roux-en-Y internal drainage and gastric posterior wall cystogastrostomy were effective methods. The drainage through small cut of the gastric posterior wall and cystojejunoctomy with nipple shape have been introduced by our contrivance. Conclusions: The ultrasonograph and computer tomograph are effective in diagnosis of pancreatic pseudocyst. The choice for therapy of the disease should be based on the couse of disease and cyst size.The operation should be simple and effective.