Nghiên cứu đặc điểm lâm sàng và một số phương pháp chẩn đoán hình ảnh ở bệnh nhân nang giả tụy được dẫn lưu qua siêu âm nội soi

Abstract

Objective: To evaluate the clinical features and diagnotic imaging methods in patients with endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocyst. Subject and method: A cross-sectional descriptive study on 60 pancreatic pseudocyst patients who underwent EUS-guided pancreatic pseudocyst drainage at Cho Ray Hospital from January 2016 to August 2019. Result: The mean age of the patients was 37.6 ± 12.2 years old. Males were more likely than females with the male/female ratio = 6.5/1. The most common clinical symptoms were abdominal pain (95%) and abdominal mass (65%). The results of laboratory tests: Mean amylasemia: 435.6 ± 747.5mg/dL, mean amylasuria: 5196.1 ± 12775.8mg/dL, average of amylase/PPC fluid: 22383.9 ± 25351.3U/L, mean CEA/PPC fluid: 8.2 ± 41.4ng/mL. The mean PPC size on abdominal ultrasound, computed tomography and endoscopic ultrasound (SANS) was 12.5 ± 3.9cm, 13.4 ± 4.4cm and 12.4 ± 3.9cm, respectively. The body and tail of the pancreas was the most common location on CT with the rate of 61.7%. Patients with PPC size > 100mm had more clinical symptoms than patients with PPC size < 100mm. On upper GI endoscopy, 80% of patients had signs of PPC pressing on the gastroduodenal wall (bulging sign). The results of the EUS-guided pancreatic pseudocyst drainage had a technical success rate of 96.5% (58/60 patients), the overall success rate was 96.5% (56/58 patients), the rate of adverse events and complications of the technique was 11.7%. Conclusion: Through study on 60 patients with pancreatic pseudocyst that underwent EUS-guided pancreatic pseudocyst drainage, clinical symptoms such as abdominal pain and abdominal mass were the most common symptoms. Computed tomography and abdominal ultrasound are the most commonly used imaging modalities in the initial diagnosis of pancreatic pseudocysts, endoscopic ultrasonography is an imaging tool that contributes to the definitive diagnosis. EUS-guided pancreatic pseudocyst drainage have a high success rate, effectiveness and safety. Therefore, EUS-guided pancreatic pseudocyst drainage is the treatment method that should be chosen in the treatment of pancreatic pseudocysts at present.