ksmaКубанский научный медицинский вестникKuban Scientific Medical Bulletin1608-62282541-9544Kuban State Medical University10.25207/1608-6228-2021-28-4-85-99ksma-2541Research ArticleОБЗОРЫREVIEWСовременный подход к лечению псевдокист поджелудочной железы: систематический обзорCurrent treatment of pancreatic pseudocysts: a systematic reviewhttps://orcid.org/0000-0003-2885-7674ДурлештерВ. М.DurleshterV. M.

Дурлештер Владимир Моисеевич — доктор медицинских наук, профессор, заведующий кафедрой хирургии № 3 ФПК и ППС; заместитель главного врача по хирургии

ул. им. Митрофана Седина, д. 4, г. Краснодар, 350063

ул. Красных партизан, д. 6/2, г. Краснодар, 350012

Vladimir M. Durleshter — Dr. Sci. (Med.), Prof., Head of Chair of Surgery No. 3, Faculty of Advanced Vocational Training and Retraining; Deputy Chief Physician for Surgery

Mitrofana Sedina str., 4, Krasnodar, 350063

Krasnykh Partizan str., 6/2, Krasnodar, 350012

https://orcid.org/0000-0003-1645-0412ГенрихС. Р.GenrikhS. R.

Генрих Станислав Робертович — доктор медицинских наук; профессор кафедры хирургии № 3 ФПК и ППС; заведующий хирургическим отделением государственного бюджетного учреждения здравоохранения «Краевая клиническая больница № 2» Министерства здравоохранения Краснодарского края

ул. им. Митрофана Седина, д. 4, г. Краснодар, 350063

Stanislav R. Genrikh — Dr. Sci. (Med.), Prof., Chair of Surgery No. 3, Faculty of Advanced Vocational Training and Retraining; Head of the Surgery Unit, Territorial Clinical Hospital No. 2 

Mitrofana Sedina str., 4, Krasnodar, 350063

https://orcid.org/0000-0002-8400-2200МакаренкоА. В.MakarenkoA. V.

Макаренко Александр Владимирович — кандидат медицинских наук, ассистент кафедры хирургии № 3 ФПК и ППС; заведующий хирургическим отделением № 4

ул. им. Митрофана Седина, д. 4, г. Краснодар, 350063

ул. Красных партизан, д. 6/2, г. Краснодар, 350012

Alexander V. Makarenko — Cand. Sci. (Med.), Research Assistant, Chair of Surgery No. 3, Faculty of Advanced Vocational Training and Retraining; Head of Surgery Unit No. 4 

Mitrofana Sedina str., 4, Krasnodar, 350063

Krasnykh Partizan str., 6/2, Krasnodar, 350012

https://orcid.org/0000-0002-2512-219XКиракосянД. С.KirakosyanD. S.

Киракосян Дивин Симонович — аспирант кафедры хирургии № 3 ФПК и ППС; врач-хирург хирургического отделения № 1

ул. им. Митрофана Седина, д. 4, г. Краснодар, 350063

ул. Красных партизан, д. 6/2, г. Краснодар, 350012

проезд Дальний, д. 9, корп. 2, кв. 7, г. Краснодар, 350028 

тел.: +7 (988) 387-23-24 

Divin S. Kirakosyan — Postgraduate Student, Chair of Surgery No. 3, Faculty of Advanced Vocational Training and Retraining; Surgeon, Surgery Unit No. 1 

Mitrofana Sedina str., 4, Krasnodar, 350063

Krasnykh Partizan str., 6/2, Krasnodar, 350012

Proezd Dalniy str., 9, korp. 2, r. 7, Krasnodar, 350028 

tel: +7 (988) 387-23-24

divin93@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Государственное бюджетное учреждение здравоохранения «Краевая клиническая больница № 2» Министерства здравоохранения Краснодарского краяРоссияKuban State Medical University; Territorial Clinical Hospital No. 2Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKuban State Medical UniversityRussian Federation2021150620212848599Copyright © Дурлештер В.М., Генрих С.Р., Макаренко А.В., Киракосян Д.С., 20212021Дурлештер В.М., Генрих С.Р., Макаренко А.В., Киракосян Д.С.Durleshter V.M., Genrikh S.R., Makarenko A.V., Kirakosyan D.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ksma.elpub.ru/jour/article/view/2541

Введение. Проблема образования псевдокист поджелудочной железы является одной из актуальных в современной медицине. Лечение данной группы пациентов проводится с использованием различных инструментальных методов и подразумевает мультидисциплинарный подход. Хирурги и гастроэнтерологи попытались определить оптимальную тактику лечения псевдокист поджелудочной железы, чтобы уменьшить количество осложнений и частоту рецидивов. По результатам этих исследований транскутанное дренирование под УЗ-контролем, лапароскопическое дренирование и дренирование при помощи гибкой эндоскопии стали многообещающими методами лечения.Цель обзора — обобщение диагностических и терапевтических методов, используемых для лечения псевдокист поджелудочной железы, и сравнение транскутанного дренирования под УЗ-контролем с хирургическим и эндоскопическим дренированием.Методы. В настоящем обзоре изучалась классификация псевдокист поджелудочной железы, их эпидемиология, методы диагностики и лечения. В обзор вошли только сравнительные, полнотекстовые исследования, опубликованные с 2014 по 2021 год, а также отдельные значимые публикации с 2002 по 2013 г. Анализ проводился с использованием поисковых систем Elibrary, Elsevier, PubMed по заголовку в названии статьи или журнала «псевдокиста поджелудочной железы», «дренирование псевдокисты», «хирургическое дренирование», «эндоскопическое дренирование», «цистогастростомия», «гастроеюностомия», «цистодуоденоанастомоз», «транспапиллярное дренирование», «трансмуральное дренирование и эзофагогастродуоденоскопия». Текстовые запросы использовались отдельно или в комбинации. Отбор научных работ проведен в зависимости от их научной ценности относительно темы исследования.Результаты. Основу систематического обзора составляют данные 68 научных работ по исследуемой теме. В статье рассмотрены наиболее часто применяемые методы хирургического лечения псевдокист поджелудочной железы. В зависимости от принципа лечения используемые методы разделены на три группы: транскутанное дренирование под УЗ-контролем, хирургическое дренирование и дренирование при помощи гибкой эндоскопии. Освещены основные классификации и методы лечения, их преимущества и недостатки.Заключение. На сегодня в клинической практике отсутствует общепринятая схема лечения псевдокист поджелудочной железы. Нет сведений об использовании определенного метода лечения на большой группе пациентов. По результатам проведенного анализа публикаций такие методы лечения, как транскутанное дренирование, хирургическое дренирование и эндоскопические дренирование под контролем УЗИ, показали высокую эффективность среди всех методов хирургического лечения.

Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices.Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques.Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value.Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages.Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.

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The authors declare that there are no conflicts of interest present.