Kune varwere vane pancreatic pseudocysts, kushanda kweiyo nyowani kaviri howa musoro simbi stent yakakura.

Pancreatic pseudocyst nderimwe rematambudziko epancreatitis, sezvo zviratidzo zvaro zvinodzokororwa zvine chekuita nehupenyu hwevarwere. Parizvino, nzira dzekurapa dzepancreatic pseudocysts dzinosanganisira kurapwa kwekuvhiya, percutaneous puncture drainage, uye endoscopic transluminal drainage. Mumakore achangopfuura, endoscopic transluminal drainage yave zvishoma nezvishoma yave yakajairika nzira yekurapa, inonyanya kutungamirwa ne endoscopic ultrasound (EUS) yekumisikidza inoshanda nzira yemvura pakati pe cyst nedumbu kana duodenum, kuitira kuti iwane mukati memvura ye cyst. Mukuita kwekiriniki, marudzi akasiyana-siyana emastents anowanzoiswa pakati pematanho kuti ave nechokwadi chekuvhurika kwavo kwakanaka.

Kune marudzi akasiyana-siyana emastents mumakiriniki ekudzidzira, uye iyo inowanzo shandiswa kaviri pigtail stent ine njodzi yakaderera yekubviswa stent. Nekudaro, nekuda kwediki dhayamita yemukati, stent blockage inowanzoitika. Yakavharwa zvakazara inozvikudza simbi stents ine zvakanakira senge yakakura yemukati dhayamita, yakaderera njodzi yekuvharika, uye yakanaka yemvura mhedzisiro yemacysts. Mumakore achangopfuura, South Korea yakagadzira mhando nyowani yekaviri howa musoro stent (Mufananidzo 1), iyo ine dhayamita yakakura uye kureba, uye yakashongedzerwa ine yakatsaurirwa kuendesa catheter. Zvidzidzo zvakapfuura zvakaona kuti iyi stent nyowani ine hunyanzvi hwekiriniki.

Cyst inoratidzwa pana MR

Iyo gastric cavity inomanikidzwa uye inova diki

Pseudocyst pasi pe endoscopic ultrasound

Inokurumidza kubuda mvura mushure mekuisa stent

Research In roduction

Ongororo yakaitwa muSouth Korea yakaratidza kuti kune varwere vane symptomatic pancreatic pseudocysts, kushandiswa kwekaviri howa musoro simbi stent kunogona zvinobudirira kuderedza zviratidzo, kubvisa pancreatic cysts, uye yakachengeteka. Chinyorwa chakaburitswa munaGunyana chinyorwa cheGastrointestinal Endoscopy (2019, 90 (3): 507-513).

Ichi chidzidzo chaisanganisira varwere vane symptomatic pancreatic pseudocysts, iyo ine dhayamita yakakura kupfuura 6 cm, isina zvikamu zvemukati, uye iri pedyo negastric uye duodenal cavities. Kusasanganisa vanhu vane zvinhu zvakasimba mupseudocysts, vanhu vakafa vane maronda akavharidzirwa, uye vanhu vane pseudocysts vasingagone kurapwa pasi pekutungamirwa kweEUS. Kune varwere vakanyoresa, yekutanga EUS inotungamirirwa puncture inoitwa kuti igadzire nzira kuburikidza negastric kana duodenal cavity uye cyst, inoteverwa nekuwedzera uye kuvhiyiwa kwekuvakazve uye kuiswa kwekaviri howa musoro stent. CT scan yakaitwa mavhiki e4 mushure mekurapa kuti iongorore kushandiswa kwemvura ye cyst (Mufananidzo 2).

Mufananidzo 2: Kurapa kwepancreatic pseudocyst uchishandisa mutsva kaviri howa musoro simbi stent: A, CT inoratidza yakakura pancreatic pseudocyst; B. EUS inotungamirirwa transgastric cyst puncture oparesheni; C. Tarisa waya yegwara ichipinda mukati me cyst pasi pe X-ray fluoroscopy; D. Kuiswa kweSPAXUS stent pasi pehutungamiri hweEUS; E. Inooneka stent kuiswa pasi pe X-ray fluoroscopy; F. Kucherechedza zvakabudirira kuiswa stent pasi pe endoscopy yakananga; G. CT yekutevera mifananidzo mushure mekuvhiyiwa kwekuisa stent; H. Mushure mekuiswa kwe stent, basa re stent rakaonekwa kuti rakanaka pasi pe endoscopy; I. Kubudirira kubvisa stent pasi pe endoscopy

Huwandu hwevarwere ve34 vakanyoreswa muchidzidzo, kusanganisira 26 varume nevakadzi 8, vane avhareji yemakore 51.7 makore. Avhareji dhayamita yepancreatic pseudocysts yaive 9.23 cm. Kunze kwemurwere mumwe chete akakundikana kusunungurwa kwe stent, varwere ve33 vakasara vakabudirira kupedza kuiswa kwe stent, nekubudirira kwehutano hwe 97.1% (33 / 34); Pakati pevarwere makumi matatu nevatatu vakabudirira kuisa stent, murwere mumwe chete aive asina kunaka kwemvura, nepo varwere makumi matatu nevaviri vakasara vakawana zororo rekiriniki uye kunyangarika kwecyst, nekiriniki yekubudirira kwe94.1% (32/34). Paiva nezviitiko zvitatu zvehutachiona hwepseudocyst uye 1 kesi ye stent dysfunction panguva yeperioperative nguva, ine dambudziko re 11.8% (4/34).

Mashoko enyanzvi

Nyanzvi yezvekutaura: Zhang Shutian, Beijing Friendship Hospital Yakabatana neCapital Medical University

Sechinyakare, varwere vazhinji vane pancreatic pseudocysts vanoda kurapwa kwekuvhiya kuti vawane cyst drainage uye kubviswa. Nekuvandudzwa kwe endoscopic tekinoroji, endoscopic kurapwa kwepancreatic pseudocysts zvishoma nezvishoma yave nzira yekurapa, ine hunyanzvi uye chengetedzo, asi kune zvakare mamwe matambudziko ehunyanzvi.

Nhanho yakakosha yekurapa endoscopic yepseudocysts ndeyekumisa chiteshi pakati pegumbo rekudya lumen uye cyst, uye nekuisa yakaenzana saizi stent kuti iwane mukati memvura ye cyst. Iyo dhayamita uye kureba kwe stent zvese zvinokanganisa iyo drainage maitiro. Parizvino, iyo inowanzoshandiswa kaviri pigtail plastiki stent ine dhayamita diki uye inotarirwa kuvhara; Iyo simbi yakafukidzwa stent ine hurefu hupfupi uye inokurumidza kusimuka, iyo inokanganisa maitiro ekurapa; Mumakore achangopfuura, iyo ichangobva kuvhurwa kaviri howa musoro simbi stent ine yakakura yemukati dhayamita uye inogona kugadziridzwa kusvika pakukura kwakakodzera zvichienderana nehurefu hwemadziro ekugaya uye cyst channel.

Ichi chidzidzo chekutanga chakawanda chinotarisirwa kudzidza chakanangana neinoveli stent, ichivavarira kuongorora kushanda kwayo muvarwere vane symptomatic pancreatic pseudocysts. Vatsvagiri vakatanga kushandisa 19G EUS yekubaya tsono kubaya mucyst kuburikidza negastric kana duodenal wall. Pashure pokunge chibharumu chanyungudutswa kuita chiteshi chakakura zvakafanira, catheter inoenderana nayo yakaiswa uye stent yakaiswa. Mushonga wekurapa wakaongororwa zvichienderana nekureruka kwechiratidzo chemurwere uye shanduko mudhayamita ye cyst.