膵囊胞の治療方針

The Treatment of Pancreatic Cyst

要旨　過去10年間に，われわれの教室では30例の膵囊胞性疾患を経験した．Howardらの分類に従うと，仮性囊胞が18例で，そのうち14例が膵炎性，2例が外傷性，残り2例が腫瘍性であった．真性囊胞は12例で，うち10例が貯溜性，1例が先天性，1例が腫瘍性囊胞であった．治療法に関しては，仮性囊胞14例に何らかの外科的治療が行われた．真性囊胞のうち貯溜性囊胞では，すべて成因となった慢性膵炎の保存的治療が行われ，腫瘍性囊胞に対しては膵十二指腸切除術が施行された．次に，膵囊胞の治療方針に関して文献的考察を加え，膵囊胞の病態は大変複雑であり，その治療法も画一的なものではないこと，個々の病態に応じた適切な治療法を選択すべきであると結論づけた．また，囊胞に対する治療だけでなく，成因や合併する膵病変に対する治療も重要視されなければならないことは改めて強調するまでもない．

　Thirty cases of pancreatic cyst have been encountered in our institution in the last ten years. This disease was classified into two groups, pseudocyst and true cyst. The causes of pseudocyst were post-pancreatitis in 12, traumatic in 4, and tumorous cyst in 2 cases. On the other hand, among the true cysts, 10 of them were retention type, 1 of them was congenital, and the other was a tumorous cyst. Some kind of surgical therapy were performed successfully in 14 cases of pseudocyst. In the cases true pancreatic cyst, conservative therapy was applied to the causal chronic pancreatitis in 10 cases of retention cyst, and pancreatico-duodenectomy was performed in one case of tumorous cyst. The choice of the treatment method of pancreatic cyst is not so easy because of the variety of its pathogenesis. An adequate treatment method has to be chosen not only for the pancreatic cyst itself, but also for the cause of the disease and for the complications resulting from this disease.