췌장가성낭종의 임상적 고찰

Abstract

Pancreatic pseudocyst occurs rarely in the patients with pancreatitis secondary to chronic alcohol abuse, trauma and biliary disease. Recently with the advent of the computerized tomography and ultrasonography, diagnostic accuracy and incidence has been improved. It is common that unless it resolves within 6 weeks, surgical treatment is indicated. This study consists of analysis of 40 cases of pancreatic pseudocyst which were diagnosed and treated at the department of surgery, Keimyung University School of Medicine, Taegu, Korea, during 10 years from January 1976 to December 1985. The following results were obtained : 1) The most common age group was in the 5th decade (27.5%) and male to female to female ratio was 4:1 2) Among the etiologic factors of pseudocysts, abdominal trauma was the leading cause(42.5%) and alcoholism(32.5%), unknown(12.5%), biliary disease(7.5%) and malignancy(5%) were in order of frequency. 3) The most common symptom and sign were abdominal pain(87.5%) and abdominal mass (50%) 4) Diagnostic accuracy of the abdominal CT were 100%, ultrasonogram 88.9%, and UGI 78.6%. 5) The location of the pseudocyst was in the body of the pancreas in 26 cases(65%), head in 8 cases (20%), tail in 4 cases (10%), and multiple in 2 cases(5%) 6) Among 40 cases, 8 cases were resolved spontaneously ,during the follow-up. Of 32 remaining cases, internal drainage was were performed in 22 cases(68.8%), external drainage in 8 cases(25%) and resection in 2 cases(6.2%). Among the internal drainage, cystogastrostomy was carried out in 14 cases and dystojejunodstomy in 8 cases. 7) The most common postoperative complications were wound infection and pleural effusion in 4 cases respectively and pancreatic fistula in 2 cases, pneumonia in 2 cases and recurrent pseudocyst in 2 cases. Operative mortality was 6.25%.