胰腺假性囊肿内引流术式的研究

目的：探讨胰腺假性囊肿内引流术的术式选择。
方法：回顾性分析13余年收治且行囊肿内引流治疗的胰腺假性囊肿62例的临床资料，着重探讨手术方法以及效果。
结果：全组均经B超或/和CT以及术后病理学检查明确胰腺假性囊肿的诊断。行囊肿空肠Roux-en-Y型吻合术的31例，术后囊肿感染发生率为9.7%（3/31），消化道出血发生率为3.2%（1/31），无死亡病例。行囊肿胃吻合术的16例，术后囊肿感染发生率为12.5%（2/16），消化道出血发生率为37.5%（6/16），病死率为6.25%（1/16）。行序贯式囊肿外、内引流术的15例，术后囊肿感染发生率为6.7%（1/15），消化道出血发生率为13.3%（2/15），无死亡者。
结论：囊肿空肠Roux-en-Y型吻合术是安全有效的术式；对适宜行囊肿胃吻合术的囊肿，建议行序贯式囊肿外、内引流术。

Study of surgical internal drainage for pancreatic pseudocysts

Objective:To investigate the choice of  different internal drainage procedures for the treatment of pancreatic pseudocyst.
Methods:The clinical data of 62 cases diagnosed as pancreatic pseudocyst and treated by surgical internal drainage in the past 13 years were retrospectively analyzed.
Results:The diagnosis of pancreatic pseudocyst was confirmed by B-US and/or CT before operation,and confirmed by  biopsy after operation in all of the cases. Thirty-one cases underwent Roux-en-Y cystojejunostomy with 9.7% incidence of postoperative infection of pseudocyst (3/31), 3.2% incidence of postoperative gastrointestinal bleeding(1/31), and no deaths. Sixteen cases underwent cystogastrostomy with12.5% incidence of postoperative infection of pseudocyst (2/16),  37.5% incidence of postoperative gastrointestinal bleeding(6/16), and 6.25% case fatality(1/16). Fifteen cases underwent sequential external and internal drainage with 6.7% incidence of postoperative infection of pseudocyst (1/15),  13.3% incidence of postoperative gastrointestinal bleeding(2/15), and no deaths.
Conclusions:Roux-en-Y cystojejunostomy is a safe and rational procedure for treatment of pancreatic pseudocyst. If the pseudocyst is suitable for cystogastrostomy, sequential external and internal drainage should be adopted instead of cystogastrostomy.