Some Problems about Management of Acute Pancreatic Pseuclocyst by CT Guided Percutaneous Drainage_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Yicun , YAO Xinmin , PU Guangchun , HUANG Jiangtao , YANG Senhua

Department of General Surgery, The Third People’s Hospital of Chengdu City, Chengdu 610031, China;

Corresponding author：

Keywords：

Acute pancreatic pseudocyst; CT guided; Percutaneous drainage; Treatment

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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.

Citation： YANG Yicun,YAO Xinmin,PU Guangchun,HUANG Jiangtao,YANG Senhua. Some Problems about Management of Acute Pancreatic Pseuclocyst by CT Guided Percutaneous Drainage. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(8): 686-688. doi: Copy

1.	王顺昌, 陈纪伟, 何跃明. 胰腺假性囊肿的研究进展 [Ｊ]. 国际外科学杂志, 2006; 33(1): 31-34.
2.	刘震杰, 沈来根. 胰腺假性囊肿的治疗现状及进展 [Ｊ]. 国际外科学杂志, 2006; 33(3): 189-192.
3.	吴阶平, 裘法祖, 黄家驷主编. 外科学 [M]. 第6版. 北京: 人民卫生出版社, 2002: 1309-1310.
4.	倪仲琳, 张伟. 胰腺假性囊肿56例临床分析 [Ｊ]. 现代中西医结合杂志, 2007; 16(13): 1782-1783.
5.	Warshaw AL, Jin GL. Improved survival in 45 patients with pancreatic abscess [Ｊ]. Ann Surg, 1985; 202(4): 408-417.
6.	Neme R, Georgescu I, Mrgritescu D, et al. The pancreatic pseudocyst-late complication of the severe acute pancreatitis. Therapeutic options [Ｊ]. Chirurgia (Bucur), 2006; 101(3): 259-265.
7.	Morton JM, Brown A, Galanko JA. A national comparison of surgical versus percutaneous drainage of pancreatic pseudocysts: 1997-2001 [Ｊ]. J Gastrointest Surg, 2005; 9(1): 15-21.
8.	Oglevie SB, Casola C, vanSonnenberg E, et al. Percutaneous abscess drainage: current applications for critically ill patients [Ｊ]. Intensive Care Med, 1994; 9(4): 191-206.
9.	Criado E, De Stefano AA, Weiner TM, et al. Long term results of percutaneous catheter drainage of pancreatic pseudocysts [Ｊ]. Surg Gynecol Obstet, 1992; 175(4): 293-298.
10.	Colhoun E, Murphy JJ, MacErlean DP. Percutaneous drainage of pancreatic pseudocysts [Ｊ]. Br J Surg, 1984; 71(2): 131-132.
11.	刘同喜, 鲁朝敏. 胰腺假性囊肿46例诊治体会 [Ｊ]. 实用诊断与治疗杂志, 2005; 19(11): 851-852.
12.	Nealon WH, Walser E. Surgical management of complicati-ons associated with percutaneous and/or endoscopic management of pseudocyst of the pancreas [Ｊ]. Ann Surg, 2005; 241(6): 948-960.
13.	Nealon WH, Walser E. Main pancreatic duct anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage) [Ｊ]. Ann Surg, 2002; 235(6): 751-758.
14.	Nealon WH, Walser E. Duct drainage alone is sufficient in the operative management of pancreatic pseudocyst in patients with chronic pancreatitis [Ｊ].Ann Surg, 2003; 237(5): 614-622.
15.	Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992 [Ｊ]. Arch Surg, 1993; 128(5): 586-590.
16.	罗静, 彭秋生, 姚欣敏. CT引导下经皮穿刺抽液引流诊治急性胰腺炎局部并发症 [Ｊ]. 华西医学, 2007; 22(4): 735-737.
17.	杨宁, 胡立斌, 潘杰, 等. CT引导下胰腺假性囊肿外引流术的临床应用 [Ｊ]. 中华放射学杂志, 2002; 36(10): 904-907.
18.	姚欣敏, 于澜, 张抒, 等. CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究（附43例报道） [Ｊ]. 中国普外基础与临床杂志, 2008; 15(8): 560-566.
19.	张太平, 赵玉沛, 杨宁, 等. 胰腺假性囊肿治疗方式的选择与评价 [Ｊ]. 中华外科杂志, 2005; 43(3): 149-152.
20.	VanSonnenberg E, Wittich GR, Goodacre BW, et al. Percutaneous abscess drainage: update [Ｊ]. World J Surg, 2001; 25(3): 362-372.
21.	Spivak H, Galloway JR, Amerson JR, et al. Management of pancreatic pseudocysts [Ｊ]. J Am Coll Surg, 1998; 186(5): 507-511.
22.	Himal HS, Cusimano RJ. Pancreatic pseudocysts: the role of percutaneous catheter drainage [Ｊ]. Can J Surg, 1992; 35(4): 403-406.
23.	VanSonnenberg E, Wittich GR, Chon KS, et al. Percutaneous radiologic drainage of pancreatic abscesses [Ｊ]. AJR Am J Roentgenol, 1997; 168(4): 979-984.
24.	吴戈, 徐国辉, 李政文, 等. 经皮穿刺置管引流联合生长抑素治疗胰腺假性囊肿 [Ｊ]. 介入放射学杂志, 2006; 15(11): 694-695.
25.	Boerma D, Obertop H, Gouma DJ. Pancreatic pseudocysts in chronic pancreatitis. Surgical or interventional drainage? [Ｊ]. Ann Ital Chir, 2000; 71(1): 43-50.
26.	姚建高, 周蒙滔, 张启渝. 用三种方法治疗重症急性胰腺炎所致并发症的分析 [Ｊ]. 中华肝胆外科杂志, 2003; 9(11): 740-742.
27.	葛春林, 郭克建, 宋茂民, 等. 生长抑素在重症急性胰腺炎治疗中的临床观察 [Ｊ]. 中国医科大学学报, 2002; 31(3): 217-219.
28.	vanSonnenberg E, Wittich GR, Casola G, et al. Percutaneous drainage of infected and noninfected pancreatic pseudocysts: experience in 101 cases [Ｊ]. Radiology, 1989; 170(3 Pt 1): 757-761.
29.	Anderson R, Janzon M, Sundberg I, et al. Management of pancreatic pseudocysts [Ｊ]. Br J Surg, 1989; 76(6): 550-552.
30.	Andrén-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part Ⅰ: classification, pathophysiology, anatomic considerations and treatment [Ｊ]. JOP, 2004; 5(1): 8-24.

1. 王顺昌, 陈纪伟, 何跃明. 胰腺假性囊肿的研究进展 [Ｊ]. 国际外科学杂志, 2006; 33(1): 31-34.
2. 刘震杰, 沈来根. 胰腺假性囊肿的治疗现状及进展 [Ｊ]. 国际外科学杂志, 2006; 33(3): 189-192.
3. 吴阶平, 裘法祖, 黄家驷主编. 外科学 [M]. 第6版. 北京: 人民卫生出版社, 2002: 1309-1310.
4. 倪仲琳, 张伟. 胰腺假性囊肿56例临床分析 [Ｊ]. 现代中西医结合杂志, 2007; 16(13): 1782-1783.
5. Warshaw AL, Jin GL. Improved survival in 45 patients with pancreatic abscess [Ｊ]. Ann Surg, 1985; 202(4): 408-417.
6. Neme R, Georgescu I, Mrgritescu D, et al. The pancreatic pseudocyst-late complication of the severe acute pancreatitis. Therapeutic options [Ｊ]. Chirurgia (Bucur), 2006; 101(3): 259-265.
7. Morton JM, Brown A, Galanko JA. A national comparison of surgical versus percutaneous drainage of pancreatic pseudocysts: 1997-2001 [Ｊ]. J Gastrointest Surg, 2005; 9(1): 15-21.
8. Oglevie SB, Casola C, vanSonnenberg E, et al. Percutaneous abscess drainage: current applications for critically ill patients [Ｊ]. Intensive Care Med, 1994; 9(4): 191-206.
9. Criado E, De Stefano AA, Weiner TM, et al. Long term results of percutaneous catheter drainage of pancreatic pseudocysts [Ｊ]. Surg Gynecol Obstet, 1992; 175(4): 293-298.
10. Colhoun E, Murphy JJ, MacErlean DP. Percutaneous drainage of pancreatic pseudocysts [Ｊ]. Br J Surg, 1984; 71(2): 131-132.
11. 刘同喜, 鲁朝敏. 胰腺假性囊肿46例诊治体会 [Ｊ]. 实用诊断与治疗杂志, 2005; 19(11): 851-852.
12. Nealon WH, Walser E. Surgical management of complicati-ons associated with percutaneous and/or endoscopic management of pseudocyst of the pancreas [Ｊ]. Ann Surg, 2005; 241(6): 948-960.
13. Nealon WH, Walser E. Main pancreatic duct anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage) [Ｊ]. Ann Surg, 2002; 235(6): 751-758.
14. Nealon WH, Walser E. Duct drainage alone is sufficient in the operative management of pancreatic pseudocyst in patients with chronic pancreatitis [Ｊ].Ann Surg, 2003; 237(5): 614-622.
15. Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992 [Ｊ]. Arch Surg, 1993; 128(5): 586-590.
16. 罗静, 彭秋生, 姚欣敏. CT引导下经皮穿刺抽液引流诊治急性胰腺炎局部并发症 [Ｊ]. 华西医学, 2007; 22(4): 735-737.
17. 杨宁, 胡立斌, 潘杰, 等. CT引导下胰腺假性囊肿外引流术的临床应用 [Ｊ]. 中华放射学杂志, 2002; 36(10): 904-907.
18. 姚欣敏, 于澜, 张抒, 等. CT引导下经皮穿刺诊治重症急性胰腺炎局部并发症的临床研究（附43例报道） [Ｊ]. 中国普外基础与临床杂志, 2008; 15(8): 560-566.
19. 张太平, 赵玉沛, 杨宁, 等. 胰腺假性囊肿治疗方式的选择与评价 [Ｊ]. 中华外科杂志, 2005; 43(3): 149-152.
20. VanSonnenberg E, Wittich GR, Goodacre BW, et al. Percutaneous abscess drainage: update [Ｊ]. World J Surg, 2001; 25(3): 362-372.
21. Spivak H, Galloway JR, Amerson JR, et al. Management of pancreatic pseudocysts [Ｊ]. J Am Coll Surg, 1998; 186(5): 507-511.
22. Himal HS, Cusimano RJ. Pancreatic pseudocysts: the role of percutaneous catheter drainage [Ｊ]. Can J Surg, 1992; 35(4): 403-406.
23. VanSonnenberg E, Wittich GR, Chon KS, et al. Percutaneous radiologic drainage of pancreatic abscesses [Ｊ]. AJR Am J Roentgenol, 1997; 168(4): 979-984.
24. 吴戈, 徐国辉, 李政文, 等. 经皮穿刺置管引流联合生长抑素治疗胰腺假性囊肿 [Ｊ]. 介入放射学杂志, 2006; 15(11): 694-695.
25. Boerma D, Obertop H, Gouma DJ. Pancreatic pseudocysts in chronic pancreatitis. Surgical or interventional drainage? [Ｊ]. Ann Ital Chir, 2000; 71(1): 43-50.
26. 姚建高, 周蒙滔, 张启渝. 用三种方法治疗重症急性胰腺炎所致并发症的分析 [Ｊ]. 中华肝胆外科杂志, 2003; 9(11): 740-742.
27. 葛春林, 郭克建, 宋茂民, 等. 生长抑素在重症急性胰腺炎治疗中的临床观察 [Ｊ]. 中国医科大学学报, 2002; 31(3): 217-219.
28. vanSonnenberg E, Wittich GR, Casola G, et al. Percutaneous drainage of infected and noninfected pancreatic pseudocysts: experience in 101 cases [Ｊ]. Radiology, 1989; 170(3 Pt 1): 757-761.
29. Anderson R, Janzon M, Sundberg I, et al. Management of pancreatic pseudocysts [Ｊ]. Br J Surg, 1989; 76(6): 550-552.
30. Andrén-Sandberg A, Dervenis C. Pancreatic pseudocysts in the 21st century. Part Ⅰ: classification, pathophysiology, anatomic considerations and treatment [Ｊ]. JOP, 2004; 5(1): 8-24.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Some Problems about Management of Acute Pancreatic Pseuclocyst by CT Guided Percutaneous Drainage

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