ObjectiveTo determine the characters of symptomatic pancreatic pseudocyst due to acute pancreatitis and effects of surgical treatment with two kinds of procedure （internal drainage or external drainage）. MethodsOne hundred and fifteen cases hospitalized during recent ten years were retrospectively analyzed.ResultsWe found that necrotic tissue existed in the pseudocyst in most cases and infection might occur in these pseudocyst. Although effect of two kinds of surgery was similar, the clinical course was different. The complications after surgery were fewer in patients underwent internal drainage than that with procedure of external drainage, and average hospital day was 7d in cases with internal drainage and 11d in cases with external one respectively. Surgery of internal drainage used in treatment was not only successful in noninfectious and single pseudocyst, but in infectious or multiple seudocyst.ConclusionInternal drainage should be used in most cases and considered as the first selection in surgery of pseudocyst due to acute pancreatitis.
Objective To summarize some problems about the management of acute pancreatic pseuclocyst (PPC) by CT guided percutaneous drainage (PCD).Methods The recent domestic and foreign literatures were reviewed in order to explore the research advancement, such as indication, applied time, technique skill, complication and curative effect by CT guided PCD. Results This operation could be early performed in patients with acute PPC, preventing and decreasing the incidence of possible complications resulted from the traditional long-term observation and waiting. The technique skill of operation was easy with low incidence of complications and the effect was good. Combined use of somatostatin might shorten the treatment time. Some patients could be postoperatively managed in out-patient, thus the expense could be cut down. Conclusions CT guided PCD is a minimally invasive operation and is easy to perform with high effective rate and low incidence of complications and low cost. Reasonable selection of the indications and improvement of equipments and operation techniques may be helpful to improve the curative effect. The extended application of this operation is advised.
目的 探讨胰腺假性囊肿行内引流治疗的临床效果。方法 对我院2001年1月至2008年12月期间收治的20例胰腺假性囊肿行内引流治疗的临床资料进行回顾性分析。结果 本组20例中行囊肿与胃吻合7例,囊肿与空肠Roux-en-Y吻合13例。14例获得3个月~6年（平均32个月）随访，均获一次性治愈，无近、远期并发症发生。结论 根据囊肿形成的大小和时间选择恰当的内引流治疗方式，能有效治愈胰腺假性囊肿。
ObjectiveTo explore the current status and tendency of the application of CT or MRI in the pancreatic pseudocyst using bibiometric analysis for relative documents, and provide reference information for the future research of radiology. MethodsBibliographies from research literatures of CT or MRI application in the pancreatic pseudocyst from January 1, 2003 to September 20, 2014 in PubMed database were downloaded.The publication years, journals, the first authors, and the frequency of subject headings and subheadings were extracted from them by Bicomb 2.0 software.The subject headings and subheadings appeared more than five times were intercepted as high frequency ones, then created the high frequency subject headings and subheadings co-occurrence matrix.SPSS 22.0 statistical software was applied for clustering analysis with this matrix, then got the major hotspots. ResultsA total of 342 literatures were screened out.The research of CT or MRI application in the pancreatic pseudocyst increased slowly year by year in recent 10 years, then slowly decreased after 2008 year.The related literatures were published in the 164 journals, in which 16 journals (115 literatures were published) were core area distribution according to the Bradford law.There were 10 authors at least 2 published literatures, in who Bhasin DK in USA published 7 literatures, was the most active researcher in this field.The number of high frequency subject headings and subheadings was 33 and among which 5 research hotspots were clustered. ConclusionResearch hotspots about CT or MRI application in pancreatic pseudocyst mainly focuses on five aspects below:pathology, diagnosis, therapy, complications, and etiology.
目的 探讨急性胰腺炎后网膜囊早期症状性和感染性假性囊肿的手术引流治疗。 方法 对8例网膜囊早期症状性或感染性假性囊肿行内引流和外引流相结合的引流效果进行临床观察和分析。 结果 内、外引流相结合的方法治疗8例早期症状性假性囊肿或感染性假性囊肿均获得治愈，无并发症。 结论 在急性胰腺炎后早期的网膜囊症状性或感染性假性囊肿的治疗中，内、外引流相结合的治疗方法有更大的适应范围，可以取内、外引流之利，弃内、外引流之弊。
Objective To summarize the experience of sequentially minimally invasive treatment for aged and high risk symptomatic pancreatic pseudocyst under ultrasound guided percutaneous catheter drainage combined with endoscopic technique. Methods The clinical data of 30 patients with aged and high risk pancreatic pseudocyst treated from January 2009 to January 2012 in this hospital were analyzed retrospectively. Results Percutaneous tubes were successfully placed in 30 patients， cystic liquid was sufficiently drained， and the compression symptom of cyst was relieved immediately. After stable disease， 12 patients with communicating cysts were diagnosed by using endoscopic retrograde cholangiopancreatography. Pancreatic duct stents were inserted in 12 patients with communicating cysts for 60-90d （with an average 70d） after endoscopic sphincterectomy and endoscopic pancreatic sphincterectomy. Cysts disappeared in the other 18 cases receiving external drainage with external drainage tubes， the drainage time was 15-90 d with an average 30d. Neither recurrence nor complications were found in all the cases during 12-21 months （with an average 18 months） follow-up. Conclusion Interventional ultrasound combined with endoscopic technique sequentially minimally invasive treatment for aged and high risk symptomatic pancreatic pseudocyst has superiorities in little trauma， fewer complications， and exact effect.
Objective To explore treatment strategy of pancreatic pseudocyst induced left-sided portal hypertension (LSPH) complicated with hypersplenism. Methods The clinical data of 49 cases of pancreatic pseudocyst induced LSPH complicated with hypersplenism from January 2010 to June 2015 in this hospital were retrospectively analyzed. Among them, 36 patients who were not complicated with upper gastrointestinal bleeding were designed to splenectomy group and non-splenectomy group based on splenectomy or not. The epidemiological and clinical features, intraoperative and postoperative results of these two groups were compared. Results There were 38 males and 11 females with age ranging from 22 to 67 years old. As for 13 patients suffering LSPH complicated with hypersplenism caused by pancreatic pseudocyst with upper gastrointestinal bleeding, one patient didn’t accept splenectomy, then the upper gastrointestinal bleeding recurred and the hypersplenism was not alleviated after operation; Whereas, the hypersplenisms were relieved in the others patients after operation. In the 36 patients without upper gastrointestinal bleeding who were complicated with hypersplenism, 23 patients were performed splenectomy (splenectomy group) and 13 patients were not (non-splenectomy group). In the splenectomy group, the blood loss, operation time, and intraoperative blood transfusion were significantly more than those of the non-splenectomy group (P<0.05). The hospital stay and the discharged laboratory examinations had no significant differences between the splenectomy group and the non-splenectomy group (P>0.05) except for the platelet count. Furthermore, the incidence of the postoperative upper gastrointestinal bleeding was lower (P<0.05) and the relief rate of hypersplenism was higher (P<0.05) in the splenectomy group as compared with the non-splenectomy group. Conclusions For pancreatic pseudocyst induced LSPH with hypersplenism, we should be vigilant and early intervent. Usually, primary focus can be treated only. However, splenectomy can effectively relieve hypersplenism and prevent recurrent bleeding for patients with upper gastrointestinal bleeding or patients with close adhesion of pancreas tail and spleen inflammatory lesions and constricting splenic hilus.