Clinical Study On Endoscopy And Laparoscopy Treatment For Pancreatic Pseudocyst

Object:to inquire essentiality of the treatment in laparoscopy combined with endoscopy and how to make a reasonable algorithm in terms of efficacy and Mini-invasion of endoscopy and laparoscopy treatment for pancreatic pseudocyst.Materials and Methods:The patients with pancreatic pseudocyst who underwent endoscopy and laparoscopy Treatment in Department of Tian Jin Mini-invasive Surgery,from March 2000 to April 2008,were analysed retrospectivelyjncludeing basic condition,achievement ratio,racurrence ratio and complication etc.A total of 38patients including 14 patients performed by the endoscopy,7 patients performed by the laparoscopy and 17 patients performed by the conventional operation whose basic situations were approximate to the patients underwent the endoscopy and the laparoscopy treatment to choose to contrast referred in the study, All patients,including 29 men and 19 women with a mean age of 47 years,presented with PPc-related sysptoms:abdominal pain in 34 patients,weight lose in 17 patients, nausea and vomiting in 14 paitents,fever In 6 paitents,objective sign in 19 patients.PPcs with a mean size 8.7 cm resulted from biliary pancreatitis in 30 patients(79%),acute pancreatitis in 20 patients,chronic pancreatitis in 13 patients and traumatic occlusion pancreatitis in 5 patients.PPcs with monocyst in 34 patients located in head of pancreas in 14 patients and In body and tail of pancreas in 24 patients.All patients were followed up from 6 months to 28 months.Time of therapy,blood loss of therapy,of therapy,early complication,score of pain etc during postoperative and patient s' satisfaction were observed on the basic situation of 38 patients in the 3 groups.Results:14 patients underwent therapeutic endoscopy,8 patients were performed by ETCD with 2 patients recurrenced;2 patients were performed by gastroscope;4 patients were performed by EUS.7 patients underwent therapeutic laparoscopy,6 patients were performed by cystogastrostomy;1 patient was performed by laparoscopic cystojejunostomy.Conwentional operation performed in 17 patients, cystoduodenostomy performed in 1 patient;cystogastrostomy performed in 6 patients;cystojejunostomy performed in 10 patients In 38 patients,the efficacy of the endoscopy and the laparoscopy treatment in 14 patients was 85.7%,the efficacy of the tradational operation treatment in 17patients was 88.2%,No patients was dead, the mortality of the treatment was zero,length of patient stay was to shorten conspicuous.There are three patients under the treatment in laparoscopy combined with endoscopy successfully and effectively.Conclusion:the endoscopy and laparoscopy treatment for Pancreatic pseudocyst is safety,efficacy and Mini-invasion and they can be combined with each other, especially the treatment in laparoscopy combined with endoscopy can be apply to improve achievement ratio of minimally invisive treatment and to make a more reasonable algorithm.