Wyniki wyszukiwania - Biblioteka Nauki

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Giant Post-Inflammatory Pancreatic Cyst Associated with Giant Abdominal Hernia - a Case Report

100%

Murawa D. , Nowaczyk P. , Adamczyk B.

Polish Journal of Surgery

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2008

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tom 80

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nr 7

389-394

EN

The case of a patient who developed a giant post-inflammatory pancreatic cyst, which resulted in the development of a giant abdominal hernia, is presented. The cyst developed as a consequence of earlier shortcomings in the diagnostic and therapeutic process; cyst development was also due to the patient's irresponsible approach to the problem. The patient did not present any typical symptoms of pancreatic pseudocyst. He reported to the Surgical Outpatient Clinic in the Wielkopolska Cancer Centre because of a reduced quality of life caused by a giant abdominal hernia. Basic laboratory tests and an abdominal CT were conducted, and a decision was reached regarding laparotomy. The pseudocyst was anastomosed with the intestinal wall on Roux-en-Y loop. A prolene net was applied simultaneously, due to the extensive defects in the abdominal integuments. In this case, treatment should have been implemented at a much earlier stage, without exposing the patient to the consequences of basic disease and the presence of a foreign body (net) in the abdominal integuments.

2

Pancreatic Tail Cysts

86%

Stefański L. , Lampe P.

Polish Journal of Surgery

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2008

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tom 80

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nr 6

310-314

EN

The aim of the study was to determine the optimal surgical strategy in patients with pancreatic tail cysts infiltrating the spleen, stomach, left diaphragmatic dome, or transverse colon mesentery.Material and methods. From 1997 through 2004, 184 patients with pancreatic pseudocysts were evaluated and treated in our Department. In 63 of those cases (34.2%), the lesion was located in the tail of the pancreas, and was classified as type II or III according to D. Egidio and Schein.Results. Combined pancreatic tail and splenic resection was performed in 32 subjects (51%), 13 (20%) underwent external drainage / marsupialisation, 11 (18%) had a Roux-en-Y pancreaticocystojejunostomy, and one patient underwent a Duval operation. Endoscopic drainage to the stomach (pancreatocysto-gastrostomy) was used in one subject; another five patients who had previously undergone external drainage / marsupialisation and developed a recurrent cyst within four months after the primary procedure were selected for pancreaticocystojejunostomy. Thus, internal drainage was performed in a total of 18 patients (28%).Conclusions. Based on our experience, we prefer pancreatic tail resection (with splenectomy) in those patients who present to the hospital with involvement of the neighbouring organs.

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Diagnostyka i leczenie torbieli rzekomych i guzów torbielowatych trzustki – na podstawie materiału własnego oraz przeglądu literatury

72%

Ćwik G. , Krupski W. , Zakościelny A. , Wallner G.

Journal of Ultrasonography

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2013

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tom 13

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nr 54

263-281

EN

Pseudocysts constitute the most basic cystic lesions of the pancreas. Symptomatic cysts may be treated by means of both minimally invasive methods and surgery. Currently, it is believed that approximately 5% of cystic lesions in the pancreas may in fact, be neoplastic cystic tumors. Their presence is manifested by generally irregular multilocular structures, solid nodules inside the cyst or in the pancreatic duct, frequently vascularized, as well as fragmentary thickening of the cystic wall or septation. Aim: The aim of this paper was to present current management, both diagnostic and therapeutic, in patients with pancreatic pseudocysts and cystic tumors. The article has been written based on the material collected and prepared in the author’s Department as well as on the basis of current reports found in the quoted literature. Material and methods, results: In 2000–2012, the Second Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract treated 179 patients with cystic lesions in the region of the pancreas. This group comprised 12 cases of cystic tumors and 167 pseudocysts. Twenty-three patients (13.8%) were monitored only and 144 received procedural treatment. Out of the latter group, 75 patients underwent drainage procedures and 48 were qualified to endoscopic cystogastrostomy or cystoduodenostomy. The endoscopic procedure was unsuccessful in 11 cases (23%). In a group of patients with a pancreatic cystic tumor (12 patients), 6 of them (50%) underwent therapeutic resection of the tumor with adequate fragment of the gland. Conclusions: Endoscopic drainage is an effective and safe method of minimally invasive treatment of pancreatic cysts. The patients who do not qualify to endoscopic procedures require surgical treatment. The differentiation of a neoplasm from a typical cyst is of fundamental significance for the selection of the treatment method.

PL

Do podstawowych zmian o typie torbieli trzustki należą torbiele rzekome. Objawowe torbiele można leczyć zarówno z wykorzystaniem technik małoinwazyjnych, jak i chirurgicznie. Obecnie przyjmuje się, że w około 5% torbielowatych zmian w trzustce możemy mieć do czynienia z nowotworowymi guzami torbielowatymi. Za ich obecnością przemawiają struktury wielokomorowe, najczęściej nieregularne, lite guzki we wnętrzu torbieli lub w przewodzie trzustkowym, często unaczynione, oraz odcinkowe pogrubienie ściany torbieli lub przegrody. Cel pracy: Celem niniejszej pracy jest przedstawienie obecnej taktyki postępowania zarówno diagnostycznego, jak i terapeutycznego u chorych z pseudotorbielami oraz torbielowatymi guzami trzustki. Praca została napisana na podstawie materiału zebranego i przygotowanego w Klinice autora oraz współczesnych doniesień z zaprezentowanego piśmiennictwa. Materiał i metoda, wyniki: W latach 2000–2012 w II Klinice Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego przebywało 179 chorych z torbielowatymi zmianami w obrębie trzustki, w tej grupie stwierdzono 12 przypadków guzów torbielowatych oraz 167 zmian o charakterze rzekomych torbieli – u 23 pacjentów (13,8%) prowadzono jedynie obserwację, pozostałych 144 leczono zabiegowo. U 75 wykonano zabieg drenażowy na drodze operacyjnej, 48 chorych zakwalifikowano do endoskopowej cystogastrostomii lub cystoduodenostomii. Zabieg endoskopowy nie powiódł się u 11 leczonych (23%). W grupie pacjentów z guzem torbielowatym trzustki na 12 badanych u 6 (50%) wykonano leczniczą resekcję guza z odpowiednią częścią narządu. Wnioski: Zabiegi endoskopowego drenażu torbieli trzustki stanowią efektywną i bezpieczną metodę małoinwazyjnego leczenia. Chorzy niezakwalifikowani do zabiegu endoskopowego wymagają leczenia operacyjnego. Odróżnienie nowotworu od typowej torbieli trzustki ma podstawowe znaczenie dla kwalifikacji do sposobu leczenia.