Bakeng sa bakuli ba nang le pancreatic pseudocysts, ho sebetsa ha tšepe e ncha ea li-mushroom tse peli ho bohlokoa haholo.

Pancreatic pseudocyst ke e 'ngoe ea mathata a pancreatitis, kaha matšoao a eona a hlahang khafetsa a na le tšusumetso e kholo ho boleng ba bophelo ba bakuli. Hajoale, mekhoa ea kalafo ea pancreatic pseudocysts e kenyelletsa kalafo ea opereishene, drainage ea percutaneous puncture, le endoscopic transluminal drainage. Lilemong tsa morao tjena, endoscopic transluminal drainage butle-butle e fetohile mokhoa o tloaelehileng oa phekolo, haholo-holo o tataisoang ke endoscopic ultrasound (EUS) ho theha mocha o sebetsang oa drainage pakeng tsa cyst le mpa kapa duodenum, e le ho finyella metsi a ka hare a cyst. Litloaelong tsa bongaka, mefuta e fapaneng ea li-stents hangata e beoa lipakeng tsa likanale ho netefatsa boemo ba tsona bo botle bo bulehileng.

Ho na le mefuta e fapaneng ea li-stents ts'ebetsong ea bongaka, 'me stent e atisang ho sebelisoa habeli ea pigtail e na le kotsi e fokolang ea ho falla. Leha ho le joalo, ka lebaka la bophara ba eona bo fokolang ba ka hare, ho thibela stent hangata ho etsahala. Li-stents tsa tšepe tse ikatisang ka botlalo li na le melemo e kang bophara bo boholo ba kahare, kotsi e tlase ea ho thibela, le phello e ntle ea drainage bakeng sa li-cysts. Lilemong tsa morao tjena, Korea Boroa e hlahisitse mofuta o mocha oa hlooho ea li-mushroom tse peli (Setšoantšo sa 1), se nang le bophara bo boholo le bolelele, 'me se na le catheter e inehetseng ea ho fana ka thepa. Liphuputso tse fetileng li fumane hore stent ena e ncha e na le katleho e kholo ea bongaka.

Cyst e bontšitsoeng ho MR

Sekoti sa mala se hatelloa 'me se fetoha se senyenyane

Pseudocyst tlas'a endoscopic ultrasound

Mokelikeli o phallang ka potlako ka mor'a ho behoa ha stent

Kenyelletso ea lipatlisiso

Phuputso e entsoeng Korea Boroa e bontšitse hore ho bakuli ba nang le matšoao a pancreatic pseudocysts, tšebeliso ea tšepe e ncha ea hlooho ea li-mushroom e ka fokotsa matšoao, ea felisa pancreatic cysts, 'me e bolokehile. Sengoloa se phatlalalitsoe tokollong ea Loetse ea Gastrointestinal Endoscopy (2019, 90 (3): 507-513).

Phuputso ena e ne e kenyelletsa bakuli ba nang le matšoao a pancreatic pseudocysts, a nang le bophara bo boholo ho feta 6 cm, ha a na likarolo tse ka hare, 'me a le haufi le likoti tsa gastric le duodenal. Ho sa kenyeletsoe batho ba nang le likarolo tse tiileng ho li-pseudocysts, batho ba shoeleng ba nang le liso tse kentsoeng, le batho ba nang le li-pseudocysts tse ke keng tsa phekoloa tlas'a tataiso ea EUS. Bakeng sa bakuli ba ngolisitsoeng, ho phunngoa pele ho tataisoang ke EUS ho etsoa ho theha tselana ka gastric kapa duodenal cavity le cyst, e lateloa ke ho buoa le ho tsosolosa le ho behoa ha hlooho e ncha ea li-mushroom tse peli. CT scan e ile ea etsoa libeke tsa 4 ka mor'a phekolo ho hlahloba phello ea drainage ea cyst (Setšoantšo sa 2).

Setšoantšo sa 2: Kalafo ea pancreatic pseudocyst ho sebelisa stent e ncha ea hlooho ea li-mushroom tse peli: A, CT e bonts'a pancreatic pseudocyst e kholo; B. EUS e tataisoang ke opereishene ea ho phunya cyst transgastric; C. Sheba terata ea tataiso e kenang ka hare ho cyst tlas'a X-ray fluoroscopy; D. Ho kenngoa ha SPAXUS stent tlas'a tataiso ea EUS; E. Ho behoa ha stent ho bonahalang tlas'a X-ray fluoroscopy; F. Ho shebella stent e kentsoeng ka katleho tlas'a endoscopy e tobileng; G. CT litšoantšo tse latelang ka mor'a opereishene ea ho beha stent; H. Ka mor'a ho behoa ha stent, mosebetsi oa stent o ile oa hlokomeloa o le molemo tlas'a endoscopy; I. Ho tlosa stent ka katleho tlas'a endoscopy

Kakaretso ea bakuli ba 34 ba ngolisitsoe thutong, ho kenyeletsa banna ba 26 le basali ba 8, ka karolelano ea lilemo tsa 51.7. Ka karolelano bophara ba pancreatic pseudocysts e ne e le 9.23 cm. Ntle le mokuli a le mong ea hlōlehileng ts'ebetso ea ho lokolloa ha stent, bakuli ba setseng ba 33 ba ile ba qeta ho kenngoa ha stent ka katleho, ka tekanyo ea katleho ea theknoloji ea 97.1% (33 / 34); Har'a bakuli ba 33 ba atlehileng ho beha stent, ke mokuli a le mong feela ea ileng a ba le phello e mpe ea drainage, athe bakuli ba setseng ba 32 ba fihletse phomolo ea matšoao a kliniki le ho nyamela ha cyst, ka sekhahla sa katleho ea bongaka ea 94.1% (32/34). Ho ne ho e-na le linyeoe tse 3 tsa tšoaetso ea pseudocyst le nyeoe e le 'ngoe ea ho se sebetse ha stent nakong ea perioperative, ka tekanyo ea complication ea 11.8% (4/34).

Maikutlo a litsebi

Setsebi sa litlhaloso: Zhang Shutian, Sepetlele sa Botsoalle sa Beijing se Kopanetsoeng le Capital Medical University

Ka tloaelo, bakuli ba bangata ba nang le pancreatic pseudocysts ba hloka kalafo ea opereishene ho fumana metsi le ho felisoa ha cyst. Ka nts'etsopele ea theknoloji ea endoscopic, kalafo ea endoscopic ea pancreatic pseudocysts butle-butle e fetohile mokhoa o ka sehloohong oa kalafo, ka katleho e kholo le polokeho, empa ho boetse ho na le mathata a itseng a tekheniki.

Mohato oa mantlha oa kalafo ea endoscopic bakeng sa pseudocysts ke ho theha mocha lipakeng tsa lumen ea tšilo ea lijo le cyst, le ho beha stent e boholo bo lekaneng ho fumana drainage ea kahare ea cyst. Bophara le bolelele ba stent ka bobeli li ama phello ea drainage. Hona joale, stent ea polasetiki ea pigtail e atisang ho sebelisoa habeli e na le bophara bo fokolang 'me e atisa ho thibela; Stent e koahetsoeng ka tšepe e na le bolelele bo khutšoanyane 'me e atisa ho falla, e amang phello ea phekolo; Lilemong tsa morao tjena, tšepe ea tšepe e sa tsoa qala ea li-mushroom tse peli e na le bophara bo boholo bo kahare mme e ka fetoloa ho ea ka boholo bo loketseng ho latela bolelele ba lebota la tšilo ea lijo le kanale ea cyst.

Boithuto bona ke phuputso ea pele e lebelletsoeng ea batho ba bangata e shebaneng le "stent" e ncha, e ikemiselitseng ho lekola katleho ea eona ho bakuli ba nang le matšoao a pancreatic pseudocysts. Bafuputsi ba ile ba qala ho sebelisa nale ea 19G EUS ea ho phunya ho phunya cyst ka lerako la gastric kapa duodenal. Ka mor'a hore balune e atolosoe ho etsa mocha oa boholo bo loketseng, ho ne ho kenngoa catheter e lekanang 'me ho behoa stent. Phello ea phekolo e ile ea hlahlojoa ho itšetlehile ka phomolo ea matšoao a mokuli le liphetoho tsa bophara ba cyst.