The Diagnosis And Treatment Of Pancreatic True Cyst

Pancreatic Cyst is a kind of disease from many causes, it's relatively rare in clinical。Since the 1950s, many scholars,according to the pathogenesis and clinical experience, divided pancreatic cyst into two kinds roughly:true cyst and pseudocyst. Howard, Jones (1960), Haubrich and Berk (1976) and JiGang have made the classification method modified and corrected, make it more suitable for clinical applications. At present about pancreatic cysts classification can be roughly divided into true cysts and pseudocyst. In this proposed classification method,pancreatic true cyst (PTC) set about 10% of the total Pancreatic cysts and with the raising level of the advances in imaging technology and related auxiliary examination method, the popularity of the pancreas true cyst which can be found, compared with the past,obviously increase.1990's, domestic relevant reports about true cyst increase gradually, this disease once considered relatively rare, but now it's more familiar for surgeons.Because of its incidence is insidious, and lack of the clinical manifestations and clinical meaningful special laboratory tests index, cause the preoperative diagnosis of disease, especially early diagnosis detectional rate and accuracy low. Both at home and abroad, most scholars agree that the pathology features of cyst pancreas is that pancreatic tissue of cyst wall is epithelial cells or compound layer consists of the squamous cells, as a pathology standards to make differencal diagnosis between true cysts and pseudocyst. But in the early diagnosis standards of pancreatic cyst and suitable choice, procedures not unified standards at home and abroad. This paper patients were retrospectively summarized 34 PTC patients of third affiliated hospital of JILIN university from 2001 to 2011, analyzes the PTC clinical manifestations, radiological characteristics, pathological characteristics and treatment method. This paper's aims is to explore the diagnosis and treatment of true cyst, early diagnosis to improve the PTC and improve the detection and diagnosis of the disease, and combine accuracy, this paper discusses the specific situation for treatments.Objective:explore the effective methods of diagnosis of pancreatic true cyst and appropriate surgical interventions. Methods:a retrospective study from 34 cases of the pancreatic true cyst from 2001 to 2011.Results:34 patients, who have an average age of 22-64(34.6 years), more female than male. Patients mostly have nonspecific symptoms, and 19 patients found in routine medical examination,15 patients only have nonspecific enteron symptom or abdominal mass.34 patients are all considering pancreatic cysts before surgery, and no pancreatitis and trauma history were found before.34 patients all fininsh the operations.None of the cases have postoperative pancreatic fistula,8 cases have dropsical pancreatitis. During a mean follow-up average of 30 months (3-80 months), besdies one patient 4 years after operation died from respiratory failure,one patient do pancreatic cystadenoma resection because of the relapse, other patients were recovered well and no relapse during follow-up.Conclusion:1,the occurrence of the pancreatic true cyst, women more than men,middle-aged (30-50 years) take place more;2,pancreatic true cyst occurs more in the body and tail of pancreas;3,early diagnosis of pancreatic true cyst rely mainly on abdominal color dopplar ultrasound, and abdominal CT, both can effectively detect pancreatic true cysts, but abdominal CT (flat add enhancement) can give more accurate imaging diagnosis, help to make preoperative diagnosis and surgical implementation;4,Pancreatic true cysts with certain symptoms, its rate for completing simply cut is lower than which is of asymptomatic pancreas;5,Making choice to fit for the operation is rely on following parts;true cyst's postion, size, nature, and the relations with surrounding tissue. Pancreas true cysts which occurs in cases of pancreatic body tail, mostly choose pancreatic body tail resection, according to the specific circumstances,decide whether to do spleen or stomach and other related organ resection; For large size, with compact adhesion, cannot surgical resection, should do pancreatic cyst-gastrointestinal anastomosis; Cases occurred in pancreatic body or the pancreatic head have no fixed ways for surgery, make decision according to the concrete situation;6,occurrence of postoperative complications (pancreatic fistula, edema of pancreatitis)have no clear relationship with cystic location, surgical procedures, stimulation degree of pancreatic surgery have direct relationship with the postoperative complications.