The Using of Transcutaneous Punction and Drainage Interventions Under Ultrasonography Control in the Treatment of Patients With Pancreatic Cystic Lesions

Abstract

Summary. The relative technical simplicity of performing a transcutaneous puncture of the pancreatic cyst cavity under the control of modern medical imaging devices, as well as the simultaneous possibility of performing a minimally invasive medical and diagnostic manipulation regardless of the severity of the patient’s condition, attracts the attention of many researchers.
 The goal. The improvement of the results of treatment of cystic formations of the pancreas in patients with chronic pancreatitis with the help of minimally invasive interventions.
 Materials and methods. The retrospective results of treatment of 42 patients aged 18 to 72 years (average (36.7±8.4) years) with cystic formations of the pancreas in chronic pancreatitis for the period from 2015 to 2022, who were in the department of surgery of the liver and biliary tract of State University «Institute of General and Emergency Surgery named after V. T. Zaitsev National Academy of Sciences of Ukraine» are summarized.
 Results and their discussion. In the presence of small cystic lesions of the pancreas, not connected to the main pancreatic duct, the most appropriate method of intervention was their repeated therapeutic transcutaneous punctures under the control of ultrasonography. In patients with large cystic masses greater than 7 cm in diameter that are not connected to the main pancreatic duct, the operation of choice was long-term transcutaneous «pig tail» drainage under ultrasound guidance. Open surgical interventions (making of cystoenteroanastomoses) were performed as a second stage for patients in whom cystic formations connected with the main pancreatic duct.
 Conclusions. Treatment of patients with cystic lesions of the pancreas in chronic pancreatitis should be staged, and begin with transcutaneous fine-needle aspiration puncture of the cystic cavity. The effectiveness of treatment of cystic lesions in chronic pancreatitis can be increased due to the correct choice of indications for puncture, drainage or open traditional surgical interventions.