Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 196

The development of pancreatic fluid collections may complicate all forms of pancreatic disease, including acute pancreatitis, chronic pancreatitis, pancreatic duct injury by abdominal surgery or blunt trauma, and even pancreatic malignancy. The Revised Atlanta Classification (Table 17.1) has categorized pancreatic fluid collections into four subgroups according to the length of time since onset of pancreatic injury, presence of a mature encapsulating wall, and magnitude of solid necrotic component [1]. Pancreatic pseudocysts are walled‐off fluid collections with no or minimal solid component usually developing in the setting of chronic pancreatitis, or at least four weeks after the onset of acute pancreatitis or other pancreatic duct injury. Pathologically, pancreatic pseudocysts are surrounded by a wall of fibrous or inflammatory tissue and lack an epithelial lining. The contents are dependent on communication or otherwise with the pancreatic duct. If there is communication, the cyst will contain pancreatic juice rich in amylase, lipase, and zymogens. If there is no communication, the fluid is serous and protease‐free. Pancreatic pseudocysts are more common in chronic pancreatitis than acute pancreatitis, complicating 20–40% of cases of chronic pancreatitis compared with 5–16% of episodes of acute pancreatitis. This chapter focuses on the management of pancreatic pseudocysts; the management of other types of pancreatic fluid collections is discussed in Chapter 16.