内镜超声下胰腺假性囊肿经胃置管引流的临床研究

目的分析探讨内镜超声（EUS）下胰腺假性囊肿经胃置管引流的疗效及并发症情况。方法回顾分析2001年以来经胃置管引流胰腺假性囊肿的24例患者病历及随访资料。引流方法采用EUS引导下穿刺囊肿，插入导丝，用探条或扩张水囊行针道扩张，置入鼻囊肿引流管或1～4根双猪尾型塑料支架引流。术后定期随访，囊肿消失后拔除支架。结果24例患者均完成囊肿穿刺、置管，手术成功率100％，死亡率为0。发生并发症8例（33．3％），其中严重并发症3例（12．5％），分别为出血、感染、支架移位各1例。平均随访21．2个月，2例失访，17例假性囊肿完全消失，2例囊肿明显缩小但持续存在2年以上，腹痛症状消失，1例感染性假性囊肿内镜引流无效转外科手术。内镜引流总的有效率为86．4％（19／22），无一例复发。结论EUS下经胃置管引流治疗胰腺假性囊肿是一种安全、有效的治疗方法，其常见并发症为出血和感染。

Endoscopic ultrasound guided transgastric ancreatic pseudocyst drainage

Objective To evaluate retrospectively on the results of endoscopic pancreatic pseudo- cysts drainage and aimed to assess its safety and efficacy.Methods All consecutive patients who underwent endoscopic pancreatic pseudocyst drainage in three hospitals from January 2001 to June 2006 were included in this study.The patients' records were reviewed,and some long-term follow-up data were obtained by tele- phone at the end of the follow-up period in July 2006.Results A total of 24 patients were included(16 men and 8 women;median age 49.3 years).The technical success rate of the drainage procedure was 100% and the mortality rate was 0.Complications occurred in 8 patients(33.3%),3(12.5%)of which were ma- jor:hemorrhage in one case and secondary infection in another both of them need surgical intervention,stent shift in one case,additional endoscope treatment was required.During a median follow-up period of 21.2 months,two cases lost follow up.Among the rest 22 cases,their pseudocysts disappeared in 17 patients;two were found with much smaller persistent cyst without clinical symptoms and no additional treatment was taken in more than two years later.Recurrent cyst was never found.Overall success endoscopic drainage occurred in 19 patients(86.4%)Conclusion Endoscopic ultrasound guided transgastric drainage is an effective and safe treatment for pancreatic pseudocysts with appropriated choice of puncture site,correct installation of drainage and conjugated with antibiotics.Bleeding and secondary infection were the major complications.