假性胰腺囊肿致胃后壁穿孔11例报告

目的总结假性胰腺囊肿致胃后壁腐蚀性穿孔的临床诊治经验,探讨手术时机和手术方式。方法回顾性分析2001年8月-2006年12月手术治疗11例假性胰腺囊肿致胃后壁腐蚀性穿孔的临床资料,均为胆源性重症急性胰腺炎保守治疗4-6周患者,术前均行胃镜及CT检查而确诊;均行胆囊切除,胆总管探查T管引流,胃后壁穿孔部位环形缝扎,胃网膜囊肿内引流,胃前壁胰体尾囊肿吻合术。结果11例手术均获成功,术后1年复查胃镜及上腹部CT发现穿孔及囊肿均已痊愈。结论①胃后壁穿孔环形缝扎胃网膜囊肿内引流,胃前壁胰体尾囊肿吻合术是早期一次性手术治疗假性胰腺囊肿所致胃后壁穿孔的有效手术方式。②胃镜检查、CT检查是明确诊断、手术决策及预后评估的有效手段。③假性胰腺囊肿形成4-6周内实施内引流手术是安全有效的。

Posterior Surface Perforation of Stomach Induced by False Pancreatic Cyst (A Report of 11 Cases)

Objective To conclude the clinic experiences and the therapeutic methods for posterior surface perforation of stomach induced by false pancreatic cyst.Methods Clinical data was retrospectively analyzed in 11 cases suffered from posterior surface perforation of stomach induced by false pancreatic cyst between August 2001 to December 2006.All the patients were induced by severe acute biliary pancreatitis and were definitely diagnosed by gastroscopy and CT.The surgical manipulation included the cholecystotomy,exploration and T-tube dranage of common bile duct,cycle transfixion of the perforation,epiploic cystogastrostomy,and pancreatic cystogastrostomy.Results All the operations succeeded.The examination of gastroscope and CT showed all stomach perforations and pancreatic cysts cured 1 year after operation.Conclusions ①The method mentioned above is an effective therapy to cure the cases early by one stage for posterior surface perforation of stomach induced by false pancreatic cyst.The examinations of gastroscope aod CT are the effective methods for the diagnosis,operation decision,and prognosis appreciation.③It is safe and effective to do pancreatic cystogastrostomy in 4 to 6 weeks after the false pancreatic cyst forming.