經內視鏡逆行性胰臟導管放置術治療胰臟瘻管合併胰液外漏：病例報告

Endoscopic Retrograde Pancreatic Drainage in Treatment of Pancreatic Fistula with Peripancreatic Fluid Collection--A Case Report

胰臟假性囊腫或胰管瘻管合併胰液外漏是胰臟炎的一種合併症；有些胰臟假性囊腫或胰管瘻管會自己變小而癒合，有些卻需要治療。治療胰臟假性囊腫或胰管瘻管的方法有許多種，其中包括手術、經皮導管引流、經內視鏡引流等等。我們報告一例酒精性胰臟炎引起胰臟尾部胰管瘻管合併胰液外漏之病例，經過經皮導管引流治療之後再發。再經過內視鏡逆行性胰管放置術治療，使得胰管瘻管癒合。臨床追蹤一年後，尚未再發。我們認為利用內視鏡逆行性胰臟導管放置術，對某收胰臟假性囊腫或胰管瘻管的病例進行了治療，不失為一種簡單、且侵襲性較小的治療方式。

Pancreatic pseudocyst with fistula formation and leakage of the pancreatic fluid is one of the major complications of pancreatitis. Some fistulated pseudocyst may resolve spontaneously, and others do not but require treatment. There are many ways to treat a case with pancreatic fluid leakage, including surgery, percutaneous drainage and endoscopic drainage. We report a case of pancreatic fistula of the distal pancreatic duct resulted from massive pancreatic fluid leakage into the left perirenal space secondary to alcoholic pancreatitis. It recurred after percutaneous cystic drainage, and was successfully treated using transpapillary endoscopic retrograde pancreatic stent drainage. Follow up examinations for one year revealed no evidence of recurrence. Pancreatic stenting is a relatively simple and non-invasive method for treating some of the unresolved pancreatic pseudocyst with fistula formation, we suggest.