超声内镜引导下经胃肠道胰腺假性囊肿引流治疗： 疗效、安全性的分析报道

Endoscopic ultrasound-guided transmural drainage of pancreatic pseudocysts: the clinical analysis of safety and efficacy

摘要:

目的 观察超声内镜（EUS）引导下经胃肠道胰腺假性囊肿引流的疗效及安全性。方法 选择2008年1月～2012年12月共31例胰腺假性囊肿患者，行EUS引导下经胃肠道引流，囊肿平均最大直径9.5 cm（5～20 cm），在超声引导下选择穿刺点，用穿刺针穿刺后放r置导丝，分别使用针形刀（14例）及囊肿切开刀（11例）切开后，置双猪尾或鼻囊管引流。 结果 31例患者中1例未能成功放置引流管引流，随访5～18个月中，3例患者术后复发并再次行EUS引导下经胃肠道引流，未成功1例转外科手术治疗，术后2例患者术后出现腹膜炎，其中1例行手术治疗，另1例经内科保守治疗好转，无出血发生，无死亡发生。结论 超声内镜引导下经胃肠道胰腺假性囊肿引流术是一种安全、有效且并发症少、创伤小的方法。

Abstract:

【Objective】 To assess the safety and the efficacy of endoscopic ultrasound (EUS)-guided transmural drainage of pancreatic pseudocysts (PPC). 【Methods】 Endoscopic drainage of pancreatic pseudocysts was performed in 31 patients from Jan. 2008 to Dec. 2012. The optimal site was detected in patients underwent EUS . The needle was punctured into the PPC, the guide wire was inserted along the pinhole under X-ray, then 14 patients used the needle-knife to cut the gastric wall and pseudocysts wall, 11 patients used cyst-knife to cut the gastric wall and pseudocysts wall, then used nasal-cystic catheter drainage, or double pigtail stents internal drainage. 【Results】 Only one patient failed to drainage. Follow-up duration was 5 months to 18 months, 3 patients recrudesced and underwent EUS-guided drainage again. Peritonitis occurred in 2 patient during drainage, 1 patient treatment by surgery, 1 patient cured through medical treatment; no bleeding occurred, and no death. 【Conclusion】 EUS-guided transmural drainage of PPC is safe and effective, and less complications.