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ERCP in Evaluating The Mode of Therapy in Pancreatic Pseudocyst

机译:ERCP评价胰腺假性囊肿的治疗方式

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摘要

Twenty patients with ultrasonographic or computed tomographic diagnosis of pancreatic pseudocyst were referred for endoscopic retrograde cholangiopancreatography (ERCP). Two of these were found at laparotomy not to have pseudocysts and were excluded. Pancreatography was successful in 15 out of 18 cases (83%) and cholangiography in 12 out of 18 cases (67%). Three types of pseudocysts were noticed according to the communication of the pseudocyst to the main pancreatic duct and the presence of pancreatic duct stensosis. Successful treatment included two spontaneous resolutions, two internal drainages and three left pancreatic resections. In the eight percutaneous external drainages four recurrences (50%) occurred, one after closure of temporary pancreatocutaneous fistula. All the recurrences occurred in Type III pseudocysts with communication of the pseudocysts to stenotic main pancreatic duct. In these cases internal drainage would have been the preferable treatment method. We believe that by ERCP one can identify pseudocysts not suitable for external drainage.
机译:经超声或计算机断层扫描诊断为胰腺假性囊肿的20名患者被转诊接受内镜逆行胰胆管造影(ERCP)。在剖腹手术中发现其中两个没有假性囊肿并且被排除在外。 18例中有15例(83%)胰腺造影成功,18例中有12例(67%)胆道造影成功。根据假性囊肿与主胰管的连通以及胰腺管狭窄的存在,可发现三种类型的假性囊肿。成功的治疗包括两个自发的消退,两个内部引流和三个左胰腺切除术。在八次经皮外部引流中,发生了四次复发(50%),其中一例是暂时性胰皮肤瘘关闭后发生的。所有的复发都发生在III型假性囊肿中,假性囊肿与狭窄的主胰管相通。在这些情况下,内部排水将是首选的治疗方法。我们认为,通过ERCP,可以识别出不适合外部引流的假性囊肿。

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