经皮穿刺无水乙醇注入引流治疗胰腺假性囊肿

目的 探讨经皮穿刺无水乙醇注入引流法治疗胰腺假性囊肿(pancreatic pseudocyst,PPC)的临床价值.方法 21例D'Egidio Ⅰ型PPC患者在CT或US引导下经皮穿刺置管外引流,CT或US检查观察引流效果,无明显残腔后,夹管观察3～7 d,无异常即可拔管.经21 d引流不能痊愈者,给予每日无水乙醇20 ml囊腔注入治疗.结果 21例D'EgidioⅠ型PPC患者,经皮穿刺置管外引流后,痊愈15例,治愈率为71.43%.其余6例中,治疗有效3例,无效3例.其中1例为单房PPC并感染,2例为多房PPC无感染,3例为多房PPC合并脓肿,均经无水乙醇注入治疗6～21 d后囊腔消失,治愈率100%,无l例发生并发症,6～12个月随访无1例复发.结论 经皮穿刺无水乙醇注入引流法是治疗PPC合并感染或多房性PPC有效、安全的非手术方法,具有临床应用价值.

Treatment of pancreatic pseudocyst by percutaneous puncture and dehydrated alcohol infusion

Objective To evaluate the clinical value of infusing dehydrated alcohol on pancreatic pseudocyst (PPC). Methods Twenty one patients with D'Egidio type I PPC underwent CT or ultrasound (US) guided percutaneous catheter drainage, and CT or US were used to re-evaluate the efficacy of drainage. If no residual cavity was observed, the drainage tube was clamped for 3~7 d, and then the tube would be pulled out. Non-curative cases with catheter drainage for 21 days were given dehydrated alcohol 20 ml infusion. Results The curative rate by using percutaneous catheter drainage was 71.43% (15/21). Among the remaining 6 patients, the treatment was effective in 3 patients and ineffective in other 3 patients. 2 cases of non-infective mutli-antrum pancreatic pseudocyst, 1 case of infective single antrum and 3 cases of infective multi-antrum were included in the 6 non-curative cases, and all of them recovered completely 6~21 d after dehydrated alcohol infusion. No complication and recurrence were found during the 6~12 follow-up. Conclusions Percutaneous puncture and dehydrated alcohol infusion for infective or mufti-antrum pancreatic pseudocyst was effective and safe.