Hepato-gastroenterology · 1997
Pancreatic pseudocyst: the controversial value of total parenteral nutrition.
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Shahrudin M D, Noori S M
Аннотация
BACKGROUND/AIMS: Total parenteral nutrition (TPN) for the non-operative treatment of acute pancreatic pseudocyst has been of hypothetical benefit.
MATERIALS AND METHODS: We reviewed pseudocyst hospital admissions in 40 patients treated with TPN who had serial imaging studies. The mean cyst size was 7.4 cm on presentation, decreasing to 5.6 cm after non-operative treatment with TPN (mean 32.5 days).
RESULTS: After a non-operative period, 68 percent of pseudocysts regressed, completely in 14 percent, partially in 54 percent. Except for a patient with cyst-related obstructive jaundice, there were no complicated pseudocysts. Only 12 (28%) patients underwent cyst drainage. Fifteen patients (35%) sustained catheter-related complication, which included sepsis (26%), pneumothorax (9%), hydropneumothorax (2%), and septic right atrial thrombosis (2%), in the course of hospitalisation.
CONCLUSION: The majority of TPN-related patients had a clinical and radiographic regression of their pseudocysts. However, the increased risk of catheter-related complications in this group suggests that this therapy should be limited to patients who are unable to sustain enteral nutrition.
MATERIALS AND METHODS: We reviewed pseudocyst hospital admissions in 40 patients treated with TPN who had serial imaging studies. The mean cyst size was 7.4 cm on presentation, decreasing to 5.6 cm after non-operative treatment with TPN (mean 32.5 days).
RESULTS: After a non-operative period, 68 percent of pseudocysts regressed, completely in 14 percent, partially in 54 percent. Except for a patient with cyst-related obstructive jaundice, there were no complicated pseudocysts. Only 12 (28%) patients underwent cyst drainage. Fifteen patients (35%) sustained catheter-related complication, which included sepsis (26%), pneumothorax (9%), hydropneumothorax (2%), and septic right atrial thrombosis (2%), in the course of hospitalisation.
CONCLUSION: The majority of TPN-related patients had a clinical and radiographic regression of their pseudocysts. However, the increased risk of catheter-related complications in this group suggests that this therapy should be limited to patients who are unable to sustain enteral nutrition.
Предметные рубрики MeSH
Acute DiseaseAdolescentAdultAgedCatheterization, Central VenousCatheters, IndwellingCholestasisDrainageFemaleFollow-Up StudiesHeart AtriaHeart DiseasesHumansHydropneumothoraxMaleMiddle AgedPancreatic PseudocystParenteral Nutrition, TotalPatient AdmissionPneumothoraxRemission InductionRetrospective StudiesSepsisThrombosisTomography, X-Ray ComputedTreatment OutcomeUltrasonography