胰腺假性囊肿的非手术治疗。鉴别诊断中的问题。

U Boggi, G Di Candio, A Campatelli, A Pietrabissa, F Mosca
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引用次数: 13

摘要

结论:胰腺囊性病变的诊断存在误诊风险。认识到这个问题,了解这些病变的自然史,以及细致的治疗后随访可以减少诊断错误的后果。如果采取所有这些预防措施,胰腺假性囊肿可以安全地非手术治疗。背景:胰腺囊性病变的准确诊断一直是一个难题。本研究的目的是确定一系列经皮引流的假性囊肿诊断错误的发生率和原因,并将这些数据与文献报道的数据进行比较。方法:对70例接受经皮引流的假性囊肿患者的资料进行回顾性分析。预处理工作包括病史、体格检查、超声(US)和CT (CT)扫描、血清和囊液淀粉酶测定、囊液培养和细胞学检查。拔除引流管后,最短随访时间为12个月。结果:4例患者死亡,在拔除引流管前发现2例癌症相关假性囊肿。64例患者平均随访51.9个月(12-154个月)。在此期间,进一步发现了第三例癌症和与主要导管完全连通的粘液囊性肿瘤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nonoperative management of pancreatic pseudocysts. Problems in differential diagnosis.

Conclusion: The evaluation of pancreatic cystic lesions entails a misdiagnosis risk. Awareness of the problem, knowledge of the natural history of these lesions, and meticulous posttreatment follow-up can reduce the consequences of diagnostic errors. If all these precautions are adopted, pancreatic pseudocysts can be safely treated nonoperatively.

Background: The accurate diagnosis of pancreatic cystic lesions remains a problem. The aim of this study was to ascertain the incidence of and the reasons the diagnostic errors occurred in a series of pseudocysts drained percutaneously and to compare these data to those reported in the literature.

Methods: Data from 70 patients bearing one or more pseudocysts who underwent a percutaneous drainage were reviewed. The pretreatment workup included medical history, physical examination, ultrasound (US) and computed tomography (CT) scans, amylase assay in both the serum and the cystic fluid, culture and cytology of the cystic fluid. After removal of the drainage, the minimum follow-up period was 12 mo.

Results: Four patients died, and two cancer-associated pseudocysts were identified before removal of the drainage. Sixty-four patients were followed up for a mean of 51.9 mo (range 12-154 mo). A third cancer and a mucinous cystic tumor, fully communicating with the main duct, were further detected during this period.

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