tailieunhanh - ADVANCED DIGESTIVE ENDOSCOPY: ERCP - PART 8

Hoại tử mô tụy phức tạp biến trong một tỷ lệ phần trăm các trường hợp viêm tụy cấp tính, được nhìn thấy ít thường xuyên hơn trong các đợt kịch phát cấp tính của viêm tụy mãn tính và các tài khoản cho nhiều biến chứng và tử vong (Hình ). Etiologies có thể có một tác động vào mức độ nghiêm trọng với viêm tụy | 292 CHAPTER 11 Fig. Endoscopic transmural pseudocyst puncture and drainage a Identification of bulge into the duodenal bulb b Puncture for localization with injection of contrast and aspiration c 10 mm balloon dilation after guidewire placement d Stents in place two 10 Fr silicone pigtails and a 7 Fr nasocystic drain. appe arstobemoreinvasive morecostly anddoes not showa superioroutcome -1 1 Jt Pancreatic necrosis Necrosis of pancreatic tissue complicates acute pancreatitis in a variable percentage of cases is seen less often in acute exacerbations of chronic manlof he mplica ons d the Fig. . Etiologies may have an impact on severity with the pancreatitis p - 1 p m Tills is trial version om This is trial version WWW. adultpdf. com Table Methods of drainage and success rates in recent studies of endoscopic pseudocyst drainage. Reference All patients Cystgastrostomy alone Cystduodenostomy alone Pancreatic duct stent alone Combined procedure Patients Resolution Patients Resolution Patients Resolution Patients Resolution Patients Resolution Bardlet etal. 55 30 23 77 0 0 20 16 80 10 7 70 Grimm et al. 62 53 47 89 20 total site not specified a 16 80 29 27 93 4 4 100 b Catalano etal. 56 21 17 81 0 0 21 17 81 0 Smits etal. 51 37 24 65 10 3 30 7 7 100 12 7 58 8 7 88 Total 141 111 79 Of a total of 37 patients 26. 70 .had_resolution 82 67 82 22 18 82 Resolution refers to initial complete drainage of a pseudocyst. bThese results are not explicitly given in the study but are inferred. This is trial version WWW. adultpdf. com Table Complications recurrence rates and types of retreatment in recent studies of endoscopic pseudocyst drainage. Reference Patients Complications according to drainage type3 Initial resolution Recurrence Retreatment after recurrence Total Transmural Transpapillary Endoscopic Surgical Bardlet etal. 55 30 4 13 1 3 b 4 13 b 23 77 3 13 0 3 Grimm et al. 62 53 6 11 5 9 1 2 47 89 11 23 7C 2C Catalano .