目的

探讨胰头部囊性病变的诊治特点。

方法

33例胰头部囊性病变（假性囊肿24例，慢性胰腺炎合并胰管囊性扩张5例，囊性肿瘤4例），外引流6例，胰十二指肠切除2例，内引流23例，剖腹探查1例，未手术1例。

结果

全组康复出院，外引流4例再次手术内引流，26例获6月～9年随诊：12例有糖尿病、脂肪泻，9例有餐后消化不良，5例情况良好；7例仅获2～3月随诊，情况良好；剖腹探查及未手术各1例分别于5月、2月后死亡。

结论

影像学结合针吸囊液检查可作为诊断胰头部囊性病变的常规；无论前、后入路内引流对胰头部囊性病变均可取得良好效果，“夹心饼”式胰腺前、后方双胰肠吻合术可用于特殊病例。

Objective

To investigate the characteristics of the diagnosis and treatment the pancreatic head of cystic lesions.

Methods

33 pancreatic cystic lesions (pseudocyst 24 cases,chronic pancreatitis with pancreatic duct Saccular dilatation five cases,cystic tumors four cases), external drainage in six cases, pancreaticoduodenectomy two cases, internal drainage 23 cases, one case with exploratory laparotomy, one case without operation.

Results

all patients rehabilitation discharged. four cases with external drainage were reoperated with internal drainage, 26 cases were follow-up for six months to nine years：12 patients had diabetes and fatty diarrhea, nine cases have postprandial dyspepsia, five cases in good condition; seven cases, which were only follow-up for two to three months, in good condition;one case with laparotomy and another case without operation was died respectively after five two months.

Conclusion

The combination of imaging diagnosis and needle aspiration cystic fluid test can be used as a diagnostic conventional examination for the pancreatic cystic lesions; the good results can be all achieved regardless of the forward or backward approach of the drainage of pancreatic cystic lesions."sandwich"of anterior and rear pairs pancreaticojejunostomy can be made in special cases.