Analysis On The Therapeutic Effect Of Pancreatic Pseudocyst

Objective To compare and analysis on the therapeutic effect of Pancreatic Pseudocyst(PPC),including the conservative,the percutaneous catheter drainage(PCD),the endoscopic guided drainage,surgical treatment,in order to summarize theirs advantages and disadvantages.Methods The study retrospectively analyzed 129 patients with PPC of post-pancreatitis in Fujian Province-owned Hospital in october 1,2002 to april 1,2014,These patients divided into less than 6 cm in diameter and diameter greater than 6 cm group according to the diameter size; divided into diabetic and non-diabetic group according to whether suffering from diabetes mellitus; and divided into the conservative group,PCD group, endoscopic guided drainage group and surgical treatment group according to the treatment methods.The patient’s gender, age, clinical symptoms, the presence of diabetes, the largest diameter size of PPC before and after treatment, the total diameter size of PPC before and after treatment,the times of puncture, length of hospital stay, and complications, etc. were recorded and followed one year, comparatived the differences between each group.Results 1.In the diameter of less than 6 cm of conservative group,the cure rate was 74%,the total effective rate was 90%,no recurrence and complication,In the diameter of large than 6 cm of conservative group,the cure rate was 13%,the total effective rate was 66%,the complication incidence rate was 18%,the recurrence rate was 20%,the difference was statistically(P<0. 05). 2.In the diabetic group,the complication incidence rate was 26%,the recurrence rate was 26%,In the non-diabetic group,the complication incidence rate was 7%,the recurrence rate was 11%,the difference was statistically(P<0. 05). 3.Maximum diameter before and after treatment, total diameter before and after treatment, PPC number before and after treatment, the total efficiency, number of puncture, and complications of clinical efficacy were no statistical difference between the ultrasound guided percutaneous puncture drainage of PPC group and CT guided percutaneous puncture drainage of PPC(P >0. 05). 4.Among the diameter of larger than 6 cm of PPC, the difference between the PCD group and the conservative group was statistically(P<0. 05) with the maximum diameter after treatment(3.31±3.43cmvs6.50±3.56cm) 、 the total diameter(4.53±4.64 cm vs8.99±6.37cm)、the cure rate(39%vs13%)、the total effective rate(89%vs66%)、the recurrence rate(6%vs20%).Conclusion 1. When the diameter of PPC less than 6 cm, the duration less than 4 weeks, no complicated with other clinical symptoms, internal medicine conservative treatment may performed, when the diameter of PPC is greater than 6 cm, with or without clinical symptoms,we suggest to combine with the specific circumstances to take relatively positive clinical treatment strategy. 2. The PPC combining diabetes mellitus is easier to complicate with infection,and the recurrence rate was higher than the non-diabetes PPC. 3.Clinical effects between Ultrasound guided percutaneous puncture drainage of PPC and CT guided percutaneous puncture drainage of PPC was no significant differences. 4. Among the diameter of large than 6 cm of PPC,the PCD group was better than the conservative group in clinical effects. 5. The treatment of PPC still need a multidisciplinary analysis, take corresponding clinical strategies according to the specific circumstances.