Experience in the diagnostic and surgical treatment of pancreatic pseudocysts
DOI:
https://doi.org/10.14739/2310-1210.2015.5.53719Keywords:
Pancreatic Pseudocyst, Tomography, Ultrasonography, Drainage, LaparotomyAbstract
Actuality. Problem of surgical treatment of pancreatic pseudocysts is actual and debatable. The incidence of pancreatic pseudocysts is 0.5–1 per 100 000 adults per year, and in the overall incidence it reaches 1.6% –4.5%.
Aim. Surgical treatment results of 34 patients with pancreatic pseudocysts were analyzed to improve results of diagnostic and surgical management of pancreatic pseudocests.
Methods and results. Ultrasound scan combined with computer tomography were used for pancreatic pseudocysts diagnostic. Pancreatic pseudocysts surgical treatment was performed by minimally invasive percutaneous techniques and laparotomic surgery. Laparotomy operations were performed in 27 patients. The structure of operations was follow: external drainage of pseudocysts - 11 patients, 2 of them by minilaparotomy access, pseudocyst jejunostomy by Roux – 9 patients, pseudocyst jejunostomy with entero-enteroanastamosis by Brown – 3 patients, pseudocyst gastrostomy and pseudocyst duodenostomy – in 2 patients. Percutaneous external drainage of pancreatic pseudocysts under ultrasound control was performed in 7 patients. Indications for external percutaneous needle drainage of pancreatic pseudocysts under ultrasound control were: presence of a secure acoustic windows, lack of communication with the pancreatic pseudocysts ductal system, pseudocyst cavity diameter greater than 60 mm with wall thickness more than 3–4 mm, presence of the severe comorbidity and high operational and anesthetic risk (III–IV class ASA).
Conclusions. Analysis of early treatment results (3–6 months) found that pancreatic pseudocysts minimally invasive percutaneous puncture external drainage use in combination with ultrasound control, in addition to laparotomic operation, allows to achieve excellent and good results in 91.1% of patients.
References
Nychytailo, M. E., Snopok, Yu. V., & Bulik, I. K. (2012). Kisty i kistoznye opukholi podzheludochnoj zhelezy [Cysts and cystic tumors of pancreas]. Kyiv: Poligrafkniga. [in Ukrainian].
Kolkin, Ya. H., Khacko, V. V., Dudin, O. M., Kuz′menko, O. E., Shatalov, S. O., & Pavlov, K. I. (2011). Sovremennoe lechenie psevdokist podzheludochnoj zhelezy [Modern management of pancreatic pseudocysts]. Ukrainskij zhurnal khirurgii, 4(13), 125–128. [in Ukrainian].
Bezruchko, M. V., Malik, S. V., Kravchenko, S. P., Osipov, O. S., & Drabovskij, V. S. (2012). Vozmozhnosti ispol'zovaniya punkcionnogo drenirovaniya pod kontrolem ul'trazvukovogo issledovaniya v khirurgicheskom lechenii psevdokist podzheludochnoj zhelezy [The possibility of using the puncture drainage under the control of ultrasound in the surgical treatment of pancreatic pseudocysts]. Klinicheskaya khirurgiya, 10, 29–31. [in Ukrainian].
Kondratenko, P. G., & Dzhansyz, I. N. (2014). Taktika lecheniya parapankreaticheskogo infil'trata u bol'nykh s ostrym asepticheskim nekroticheskim pankreatitom [Tactic of treatment of parapancreatic infiltration with acute aseptic necrotizing pancreatitis]. Ukrainskij zhurnal khirurgii, 1, 9–5. [in Ukrainian].
Kolomijcev, V. I. (2009). Vybor metoda maloinvazivnogo lecheniya psevdokist podzheludochnoj zhelezy [The choice of method of minimally invasive treatment of pancreatic pseudocysts]. Ukrainskij zhurnal maloinvazivnoj i e′ndoskopicheskoj khirurgii, 2, 21–28. [in Ukrainian].
Bergman, S., & Melvin, S. W. (2007) Operative and nonoperative management of pancreatic pseudocysts. Surg. Clin. N. Am., 87, 1447–1460.
Nealon, W. H., & Walser, E. (2002) Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage). Ann. Surg, 235(6), 751–758.
Santvoort, H. C., Bakker, O. J., Bollen, T. L., Besselink, M. G., Ali, U. A., Schrijver, A. M., et al. (2011) A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology, 141(4), 1254–1263. doi: 10.1053/j.gastro.2011.06.073.
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