The impact of technology on the management of pancreatic pseudocyst. Fifth annual Samuel Jason Mixter Lecture
| Autor: | David L. Bouwman, R J Sachs, Donald W. Weaver, Alexander J. Walt |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male medicine.medical_specialty Pancreatic pseudocyst medicine.medical_treatment Diagnosis Differential Laparotomy Pancreaticojejunostomy Pancreatic Pseudocyst medicine Humans Aged Ultrasonography Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry General surgery Jaundice Middle Aged medicine.disease digestive system diseases Surgery Natural history medicine.anatomical_structure Acute pancreatitis Pancreatitis Drainage Female Laser Therapy medicine.symptom Pancreatic Cyst Pancreas business Tomography X-Ray Computed |
| Zdroj: | Archives of surgery (Chicago, Ill. : 1960). 125(6) |
| ISSN: | 0004-0010 |
| Popis: | • The records of 299 patients with 357 admissions for pancreatic pseudocysts seen between 1960 and 1989 were studied; 233 patients underwent operation. The natural history of pancreatic pseudocysts has been clarified by newer technology, such as ultrasonography, computer tomography, amylase isoenzyme measurements, and endoscopic retrograde cholangiopancreatography. All have influenced diagnosis, nonoperative management, and surgical operation. Differences between pancreatic pseudocysts associated with acute pancreatitis in contrast with chronic pancreatitis, and the complications of obstruction, hemorrhage, rupture, pancreatic ascites, infection, and jaundice can now be more rationally treated. Pancreatic pseudocysts and pancreatic ductal changes are now revealed earlier, especially by endoscopic retrograde cholangiopancreatography. Paradoxically, this information has encouraged nonoperative conservative therapy and also larger operations, eg, resection and adjunctive pancreaticojejunostomy. Partial resection of the pancreas together with the pancreatic pseudocysts was performed in 58 (25%) of the 233 patients. Recent technology permits cautious exploration of selective pancreatic pseudocyst drainage percutaneously or transgastroduodenally avoiding laparotomy. (Arch Surg. 1990;125:759-763) |
| Databáze: | OpenAIRE |
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