Clinical Study Of Endoscopic And Laparoscopic Minimally Invasive Techniques For Pancreatic Pseudocyst

Background:Pancreatic pseudocyst mostly secondary and pancreatic cancer,pancreatic trauma after by the peritoneum, omentum tissue composition, as it is called non-epithelial tissue pseudocyst.Pancreatic pseudo cyst is the most common pancreatic cystic lesions, accounting for more than 75% of all pancreatic cystic lesions. Pancreatic pseudocyst patients showed more persistent epigastric pain, and a small number of patients had upper abdominal tumors, cysts may cause abdominal pain, nausea, vomiting and other symptoms, and even cause cyst rupture, hemorrhage,necrosis caused by acute peritonitis, hemorrhagic shock and acute and severe disease.There are many methods for the treatment of pancreatic pseudo cyst, including drug conservative treatment and surgical treatment. Surgical treatment includes internal drainage, external drainage, cyst excision and pancreatectomy. Traditional surgical open surgery for patients with trauma, more complications, patients recover slowly.With the continuous development of the concept of minimally invasive and minimally invasive technique, minimally invasive surgery has gradually become the mainstream treatment method, widely used at present, and pancreatic pseudocyst of minimally invasive treatment of present diversified development, endoscopic biliary drainage and laparoscopic treatment effect is clear, can reduce trauma to the patient,shorten the patient recovery time and hospitalization time, but different methods in the treatment of adaptation different disease, there are overlapping place.Objective:The retrospective collection of pancreatic pseudocyst in patients with clinical data, analysis of pancreatic pseudocyst take effective and minimally invasive endoscopic and laparoscopic minimally invasive therapy. Further analysis of minimally invasive treatment of indications for minimally invasive treatment of pancreatic pseudocyst provide reference.Methods:Retrospective analysis from January 2012 to February 2012 in treating 68 cases of patients with pancreatic pseudocyst as the research object, by imaging and blood tests to rule out the pancreas capsule adenoma and adenocarcinoma. Patients clinical data, according to endoscopic treatment is divided into different group of 26 cases, 22 cases of laparoscopic group and laparotomy group 20 cases, including endoscopic drainage treatment group of 7 cases of the nipple, 19 cases of EUS guided cysts in the gastric duodenal drainage. In the laparoscopic group, 8 patients were treated with cyst gastric anastomosis, and the other 14 patients were treated with Roux-en-Y. In the open group, 8 cases were treated with cyst stomach anastomosis,12 cases were treated with cyst jejunum Roux-en-Y anastomosis. Patients clinical data, recording operation time, intraoperative blood loss, and record the patient treatment, length of hospital stay, postoperative pain, nausea and vomiting, bed time,complications, for the patient to carry out the follow-up work, the recurrence rate in patients with records.Results :(1) The duration of treatment, the time of hospitalization, and the time of getting out of bed were significantly shorter than that of the open group(). The amount of bleeding was significantly less than that of the open group(P<0.05).(2)The scores of pain, nausea and vomiting in the endoscopic and laparoscopic group were significantly less than that in the open group, and the postoperative exhaust time was significantly shorter than that in the open group(P<0.05).(3)There was no significant difference in the incidence of postoperative complications between the three groups(P>0.05).(4) There was no significant difference between the three therapeutic effects and postoperative recurrence rate(P>0.05).Conclusion:(1) the treatment time was short, the amount of bleeding was less, postoperative pain,nausea and vomiting, and other symptoms such as light, postoperative bed time,exhaust time and hospital stay were significantly shorter than the open group. But there was no significant difference in success rate and postoperative complication rate and recurrence rate.(2) endoscopic and laparoscopic surgery in the treatment of pancreatic pseudo cyst effective minimally invasive, less pain, shorter perioperative period, it is worth clinical promotion.