에탄올 세척술로 췌장 점액종에 의한 반복적 췌장염 발생을 예방 치료한 1예
Ethanol Lavage Therapy to Prevent Recurrent Pancreatitis in a Patient with Pancreatic Mucinous Neoplasm
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초록
췌장 낭종에서 낭종으로 인한 췌장염 발생 및 덩이 효과로 증상이 있는 경우 수술적 절제가 필요하나 환자의 연령, 기저 질환 고려하여 이환율, 사망률이 상대적으로 높아질 경우 초음파 내시경을 통한 반복적인 에탄올 세척술이 큰 합병증의 발생 없이 췌장염 발생 및 복부 증상 조절에 도움이 되었음을 보고하는 바이다.
Abstract
An 88-year-old woman diagnosed with recurrent pancreatitis and pancreatic cyst at a local clinic was admitted for upper abdominal pain. The pain was aggravated after a meal, and the patient had lost 3 kg over the past 6 months. MRCP examination revealed a 68 mm-sized septated pancreatic cyst compressing the main pancreatic duct. EUS-FNA to differentiate the cystic component retrieved a high viscosity fluid. A diagnosis of mucin-producing pancreatic cystic neoplasm was made. The patient refused surgical treatment, and alternative treatments, including methods to decompress the pancreatic cyst, were performed. The patient was treated with aspiration of cystic fluid, observation with diet control, and 99% ethanol lavage to ablate the pancreatic cyst. The treatment of 99% ethanol lavage provided the longest symptom-free period, ranging from 7 to 18 months without complications. The authors report that repeated ethanol lavage of a pancreatic cyst causing recurrent pancreatitis can be an effective treatment option for patients who are poor surgical candidates.
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