Experience On The Diagnosis And Treatment Of 50 Cases Of Children With Pancreatic Pseudocysts

Objective: To summarize the clinical features and experiences on diagnosis and treatment of children with pancreatic pseudocysts,and provide reference for the treatment method selection.Methods: A retrospective analysis was made for 50 cases of pancreatic pseudocysts diagnosed and treated in our hospital from September 2006 to August 2017,among which the clinical characteristics and key points for diagnosis and treatment were summarized.Results: 1.There were 50 children with pancreatic pseudocysts in this group.32 males and 18 females,and the ratio was approximately 1.8:1,the age ranged from 1.75 to 14.67 years with an average age of 7.83 years.2.Of the 50 patients,27(54%)had a history of definite trauma,14(28%)had a history of acute pancreatitis,and 9(18%)had unexplained causes.The clinical manifestations were abdominal pain,abdominal mass,nausea,vomiting,fever and inappetence,etc.simple abdominal pain occured in 20 cases,while abdominal pain with nausea and vomiting occured in 25 cases,abdominal mass was palpable in 28 cases.3.Of all the 50 cases,48 were diagnosised by history,clinical manifestations,amylase examination,Ultrasound and CT scan,2 cases were certified by surgical exploration.4.For 50 cases,13 were given conservation treatment,among them 10 were cured,1 was recovered well,while the other 2 had a relapse and underwent external drainage.Among the 36 cases treated with external drainage,29 cases were recovered and 5 were improved,2 cases relapsed and underwent internal drainage.5 cases treated with internal drainage were recovered well.5.After statistical analysis,the average size of cyst diameter with conservative treatment was 6.07±2.08 cm,and the average size of surgical was 9.44±3.28 cm.There were differences in conservative and surgical treatment of cyst size(P=0.000,P<0.05).There were no significant differences in efficacy between internal and external drainage(P=0.287,P<0.05).Different causes(trauma,pancreatitis)for PPC led to differences in the clinical efficacy of external drainage(P=0.008,P<0.05).The hospitalization time for internal drainage was 9±1.87 days,and the hospitalization time for external drainage was 10.08±4.77 days.There were no significant difference between them(P=0.621,P>0.05).Conclusions: The incidence of pancreatic pseudocyst in children was lower than that of adults,its diagnosis depends on personal medical history,clinical manifestations,biochemical and Radiological examination.Small cyst,no complications,whose clinical symptom are not apparent,can choose conservative treatment early.There are no obvious differences for curative effect between internal and external drainage,external drainage should be advocated because of its apparent advantages.Different etiologies,play a vital role for the choice of treatment and curative effect.For pancreatic pseudocyst caused by trauma,external drainage is prefer;while for those caused by pancreatitis,internal drainage should be advocated.