• 成都市第三人民醫(yī)院普外科（成都 610031）;

目的  總結(jié)CT引導(dǎo)經(jīng)皮置管引流（PCD）對(duì)急性胰腺假性囊腫（PPC）的有關(guān)問題。
方法  通過檢索近年來國內(nèi)、外有關(guān)文獻(xiàn)，分析總結(jié)其適應(yīng)證、使用時(shí)機(jī)、技術(shù)操作、并發(fā)癥、療效等方面的研究進(jìn)展。
結(jié)果  該術(shù)式可及早用于急性PPC，預(yù)防和減少后者因傳統(tǒng)的等待觀察而可能出現(xiàn)的并發(fā)癥。手術(shù)操作方法簡單、并發(fā)癥少、療效好，已取代某些開腹手術(shù)。加用生長抑素更可縮短療程。部分患者術(shù)后處理可在門診進(jìn)行，更節(jié)省費(fèi)用。結(jié)論  本術(shù)式系簡單而安全有效的微創(chuàng)技術(shù)，且費(fèi)用較低。認(rèn)真掌握適應(yīng)證，進(jìn)一步改進(jìn)設(shè)備和操作技術(shù)，療效將進(jìn)一步提高，值得推廣使用。

引用本文： 楊一邨,姚欣敏,蒲光春,黃江濤,楊森華. CT引導(dǎo)下經(jīng)皮置管引流治療急性胰腺假性囊腫的有關(guān)問題. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(8): 686-688. doi: 復(fù)制

1. 王順昌, 陳紀(jì)偉, 何躍明. 胰腺假性囊腫的研究進(jìn)展 [Ｊ]. 國際外科學(xué)雜志, 2006; 33(1): 31-34.
2. 劉震杰, 沈來根. 胰腺假性囊腫的治療現(xiàn)狀及進(jìn)展 [Ｊ]. 國際外科學(xué)雜志, 2006; 33(3): 189-192.
3. 吳階平, 裘法祖, 黃家駟主編. 外科學(xué) [M]. 第6版. 北京: 人民衛(wèi)生出版社, 2002: 1309-1310.
4. 倪仲琳, 張偉. 胰腺假性囊腫56例臨床分析 [Ｊ]. 現(xiàn)代中西醫(yī)結(jié)合雜志, 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. 劉同喜, 魯朝敏. 胰腺假性囊腫46例診治體會(huì) [Ｊ]. 實(shí)用診斷與治療雜志, 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. 羅靜, 彭秋生, 姚欣敏. CT引導(dǎo)下經(jīng)皮穿刺抽液引流診治急性胰腺炎局部并發(fā)癥 [Ｊ]. 華西醫(yī)學(xué), 2007; 22(4): 735-737.
17. 楊寧, 胡立斌, 潘杰, 等. CT引導(dǎo)下胰腺假性囊腫外引流術(shù)的臨床應(yīng)用 [Ｊ]. 中華放射學(xué)雜志, 2002; 36(10): 904-907.
18. 姚欣敏, 于瀾, 張抒, 等. CT引導(dǎo)下經(jīng)皮穿刺診治重癥急性胰腺炎局部并發(fā)癥的臨床研究（附43例報(bào)道） [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(8): 560-566.
19. 張?zhí)? 趙玉沛, 楊寧, 等. 胰腺假性囊腫治療方式的選擇與評(píng)價(jià) [Ｊ]. 中華外科雜志, 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. 吳戈, 徐國輝, 李政文, 等. 經(jīng)皮穿刺置管引流聯(lián)合生長抑素治療胰腺假性囊腫 [Ｊ]. 介入放射學(xué)雜志, 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, 張啟渝. 用三種方法治療重癥急性胰腺炎所致并發(fā)癥的分析 [Ｊ]. 中華肝膽外科雜志, 2003; 9(11): 740-742.
27. 葛春林, 郭克建, 宋茂民, 等. 生長抑素在重癥急性胰腺炎治療中的臨床觀察 [Ｊ]. 中國醫(yī)科大學(xué)學(xué)報(bào), 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. 1. 王順昌, 陳紀(jì)偉, 何躍明. 胰腺假性囊腫的研究進(jìn)展 [Ｊ]. 國際外科學(xué)雜志, 2006; 33(1): 31-34.
  2. 2. 劉震杰, 沈來根. 胰腺假性囊腫的治療現(xiàn)狀及進(jìn)展 [Ｊ]. 國際外科學(xué)雜志, 2006; 33(3): 189-192.
  3. 3. 吳階平, 裘法祖, 黃家駟主編. 外科學(xué) [M]. 第6版. 北京: 人民衛(wèi)生出版社, 2002: 1309-1310.
  4. 4. 倪仲琳, 張偉. 胰腺假性囊腫56例臨床分析 [Ｊ]. 現(xiàn)代中西醫(yī)結(jié)合雜志, 2007; 16(13): 1782-1783.
  5. 5. Warshaw AL, Jin GL. Improved survival in 45 patients with pancreatic abscess [Ｊ]. Ann Surg, 1985; 202(4): 408-417.
  6. 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. 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. 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. 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. 10. Colhoun E, Murphy JJ, MacErlean DP. Percutaneous drainage of pancreatic pseudocysts [Ｊ]. Br J Surg, 1984; 71(2): 131-132.
  11. 11. 劉同喜, 魯朝敏. 胰腺假性囊腫46例診治體會(huì) [Ｊ]. 實(shí)用診斷與治療雜志, 2005; 19(11): 851-852.
  12. 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. 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. 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. 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. 16. 羅靜, 彭秋生, 姚欣敏. CT引導(dǎo)下經(jīng)皮穿刺抽液引流診治急性胰腺炎局部并發(fā)癥 [Ｊ]. 華西醫(yī)學(xué), 2007; 22(4): 735-737.
  17. 17. 楊寧, 胡立斌, 潘杰, 等. CT引導(dǎo)下胰腺假性囊腫外引流術(shù)的臨床應(yīng)用 [Ｊ]. 中華放射學(xué)雜志, 2002; 36(10): 904-907.
  18. 18. 姚欣敏, 于瀾, 張抒, 等. CT引導(dǎo)下經(jīng)皮穿刺診治重癥急性胰腺炎局部并發(fā)癥的臨床研究（附43例報(bào)道） [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2008; 15(8): 560-566.
  19. 19. 張?zhí)? 趙玉沛, 楊寧, 等. 胰腺假性囊腫治療方式的選擇與評(píng)價(jià) [Ｊ]. 中華外科雜志, 2005; 43(3): 149-152.
  20. 20. VanSonnenberg E, Wittich GR, Goodacre BW, et al. Percutaneous abscess drainage: update [Ｊ]. World J Surg, 2001; 25(3): 362-372.
  21. 21. Spivak H, Galloway JR, Amerson JR, et al. Management of pancreatic pseudocysts [Ｊ]. J Am Coll Surg, 1998; 186(5): 507-511.
  22. 22. Himal HS, Cusimano RJ. Pancreatic pseudocysts: the role of percutaneous catheter drainage [Ｊ]. Can J Surg, 1992; 35(4): 403-406.
  23. 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. 24. 吳戈, 徐國輝, 李政文, 等. 經(jīng)皮穿刺置管引流聯(lián)合生長抑素治療胰腺假性囊腫 [Ｊ]. 介入放射學(xué)雜志, 2006; 15(11): 694-695.
  25. 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. 26. 姚建高, 周蒙滔, 張啟渝. 用三種方法治療重癥急性胰腺炎所致并發(fā)癥的分析 [Ｊ]. 中華肝膽外科雜志, 2003; 9(11): 740-742.
  27. 27. 葛春林, 郭克建, 宋茂民, 等. 生長抑素在重癥急性胰腺炎治療中的臨床觀察 [Ｊ]. 中國醫(yī)科大學(xué)學(xué)報(bào), 2002; 31(3): 217-219.
  28. 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. 29. Anderson R, Janzon M, Sundberg I, et al. Management of pancreatic pseudocysts [Ｊ]. Br J Surg, 1989; 76(6): 550-552.
  30. 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.