췌장 가성낭종의 예후에 영향을 미치는 인자

Abstract

Pancreatic pseudocysts are a complication of underlying pancreatic inflammation, most commonly alcohol induced pancreatitis, or of trauma. Pseudocysts present a broad spectrum of clinical findings and management must be individualized. To evaluate the factors influencing the outcome of pancreatic pseudocydts, we analysed the 41 cases of pancreatic pseudocysts who admitted to the Severance hospital from January 1980 to December 1989. The rnean age was 42.1 years and male to female ratio 2.7:1. The causes of pancreatic pseudocysts were pancreatitis in 48.8%, trauma in 36.6%, pancreatic cancer in 2.4% and unknown in 12.1%. The clinical symptoms were abdominal pain, nausea and/or vomiting, and fever and/or chill- ness', the physical signs were abdominal tenderness, palpable rnass and abdominal distension in the order of frequency. Complications were noted in 28 cases(68.3%) of the 41 cases and pleural effusion was the most commonly encountered in 34.1%, followed by ascites, infection of pseudocyst and obstructive jaundice in the order of frequency. The complications according to the cause of pseudocysts were 75.0% in those due to pancreatitis and 53.5% in trauma. Ac- cording to the size of pseudocyst there were 60.0% complications in those less than 10 cm and 81.2% in those above 10cm, and by location 75.0% in head, 73.7% in body and 50.0% in tail respectively. Surgical treatment was performed in 25 cases, improvement by conservative management in 8 cases and 5 cases were lost to follow up. Mean duration of disappearance of pseudocyst was 59.2(14 98)days and the mean size of the pseudocyst was 8.7(5 15)cm in pa- tients with improvement by conservative care. Comparison between patients with improve- ment by conservative treatment and others(except 5 cases lost to follow up) shows that spon- taneous improvement was commonly encountered in pancreatic pseudocysts causes by pancre- atitis and those less than 10cm in size. In conclusion, the pancreatic pseudocyst which is due to pancreatitis and less than 10 cm in size may be treated with conservative treatment for 2 months. However, additional study is necessary in many cases.