Pankreas psödokistlerine güncel yaklaşım: 39 olguluk serinin retrospektif analizi ve güncel literatür bilgilerinin gözden geçirilmesi

Pankreas psödokistleri akut pankreatit sonrası görülen en sık komplikasyon olmaları ve klinikte pankreasın kistik tümörleri ile karışabilmesi nedeniyle cerrahi bir problem olmaya devam etmektedirler. Günümüzde çok çeşitli cerrahi dışı tedavi yöntemleri uygulanabilmesine karşın halen cerrahi tedavi yöntemleri düşük morbidite, mortalite ve nüks oranları ile seçilmiş olgularda tercih edilen tedavi biçimi olmaktadır. Biz de bu çalışmada kliniğimizde son 10 yıl içerisinde cerrahi olarak tedavi ettiğimiz 39 pankreas psödokisti olgusunu retrospektif olarak değerlendirdik. Olguların büyük bölümüne kistogastrostomi ya da kistojejunostomi yapılırken, serimizde mortalite tespit edilmedi. Ayrıca olguların ortalama 68 ay güren takiplerinde de hiçbir hastamızda nüks gelişimi saptanmadı. Sonuçları bakımından literatür bilgileri ile karşılaştırıldığında cerrahi tedavi uygulanan seriler ile oldukça benzer sonuçlar almamıza karşın yine literatürdeki cerrahi dışı tedavi yöntemleri uygulanan serilerle karşılaştırıldığında ise sonuçlarımızın belirgin biçimde daha iyi olduğu saptandı. Günümüzde minimal invaziv biçimde yapılabilmesi nedeniyle seçilmiş olgularda etkin tedavi biçiminin laparoskopik internal drenaj işlemleri olacağı kanısına varıldı.

Current approach in pancreatic pseudocysts: Retrospective analysis of 39 cases in the light of the literature

Pancreatic pseudocysts have been one of the serious surgical problems due to being the most common complication following acute pancreatitis as well as difficult differentiation from the cystic neoplasms of the pancreas. Although the current presence of various non-surgical treatment modalities, due to the low risk of morbidity, mortality and recurrence rates, surgical therapy is the treatment of choice in selected cases. In this study we evaluated 39 cases with pancreatic pseudocysts which have been treated surgically in our clinic in the past 10 years retrospectively. Most of the cases were treated by cystogastrostomy or cystojejunostomy and no mortality occurred in the series. Moreover, no recurrence occurred during the 68 months follow up period. When our results were compared with the literature we revealed similar results in the series treated surgically whereas our results were significantly better than the series performed nonsurgical treatments. We suggest that with the advantage of the performance with minimal invasive methods, laparoscopic internal drainage procedure is an effective treatment way in the selected cases.

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Ege Tıp Dergisi-Cover
  • ISSN: 1016-9113
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1962
  • Yayıncı: Ersin HACIOĞLU
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