CAJ | 학술논문

目的探讨腹腔镜下经胃囊肿-胃内引流治疗胃后型胰腺假性囊肿的价值.方法 5例因重症胆源性胰腺炎引起的胃后型胰腺假性囊肿,非手术治疗超过2～6个月,囊肿长径分别为8、10、12、14、15 cm.采用4孔法腹腔镜下经胃前壁进入胃腔,用超声刀切开胃后壁及胰腺假性囊肿壁,切口约2～3 cm,行胰腺假性囊肿-胃内引流术.结果 5例均成功施行腹腔镜下手术,手术时间分别为90、105、115、120、150 min,术中出血量分别为100、150、150、200、300 ml.手术后无明显胃内出血征象.术后随访1个月,囊肿均消失,无急性胰腺炎复发及局部感染征象.1例术后7d发生胃瘘,经对症处理后1个月愈合.结论腹腔镜下经胃囊肿-胃内引流术治疗胰腺假性囊肿简单、有效、微创,可作为治疗胰腺假性囊肿的方法.
목적 탐토복강경하경위낭종-위내인류치료위후형이선가성낭종적개치.방법 5례인중증담원성이선염인기적위후형이선가성낭종,비수술치료초과2～6개월,낭종장경분별위8、10、12、14、15 cm.채용4공법복강경하경위전벽진입위강,용초성도절개위후벽급이선가성낭종벽,절구약2～3 cm,행이선가성낭종-위내인류술.결과 5례균성공시행복강경하수술,수술시간분별위90、105、115、120、150 min,술중출혈량분별위100、150、150、200、300 ml.수술후무명현위내출혈정상.술후수방1개월,낭종균소실,무급성이선염복발급국부감염정상.1례술후7d발생위루,경대증처리후1개월유합.결론 복강경하경위낭종-위내인류술치료이선가성낭종간단、유효、미창,가작위치료이선가성낭종적방법.
Objective To evaluate the clinical value of laparoscopic cystogastrostomy for retrogastric pancreatic pseudocysts.Methods Five patients suffering from retrogastric pancreatic pseudocysts caused by severe acute biliary pancreatitis received conservative management for 2 ～ 6 months,and the sizes of pseudocysts were 8,10,12,14,15 cm.All the 5 patients received laparoscopic cystogastrostomy,and 4 ports methods was applied,through anterior gastric wall,the posterior gastric wall and pancreatic pseudocysts were incised by using harmonic scalpel,then cystogastrostomy was performed to drain the pseudocysts.Results Laparoscopic cystogastrostomy for retrogastric pancreatic pseudocysts was successful in all patients,theoperation time was 90,105,115,120,150 minutes.The blood loss was 100,150,150,200,300 ml.No intra-gastric bleeding occurred.After 1 month follow-up,all the pseudocysts disappeared,and there was no acute pancreatitis and local infection recurrence.Gastric leakage occurred 7 d after operation in one patient,and was healed after one month of conservative management.Conclusions Laparoscopic cystogastrostomy through gastric cavity for retrogastric pancreatic pseudocysts is simple and effective,mini-invasive,and it can be an alternative therapeutic method for pancreatic pseudocysts.