Pankreas Hastalıklarında Girişimsel Radyoloji
Özet
Girişimsel radyoloji; pankreas kanseri, nekroz, psödokist ve vasküler komplikasyonların tanı ve tedavisinde minimal invaziv yöntemler sunarak hasta yaşam kalitesini artırmaktadır. Tanı aşamasında USG veya BT eşliğinde yapılan perkütan biyopsiler, özellikle tru-cut biyopsi yöntemiyle %95’e varan doğruluk oranlarına ulaşmaktadır. Akut pankreatit sonrası gelişen sıvı koleksiyonları ve psödokistlerin yönetiminde perkütan drenaj %80-90 başarı oranıyla etkin bir seçenek olup cerrahi ihtiyacını azaltmaktadır. Pankreatik nekroz durumunda ise perkütan nekrozektomi gibi kapalı yöntemler, cerrahinin yüksek mortalite riskine karşı güvenli bir alternatif sunar. Ayrıca safra yolu tıkanıklıklarında ve pankreatik kanal darlıklarında uygulanan stentleme ve perkütan transhepatik kolanjioskopi işlemleri, kanal basıncını normalleştirerek ağrı ve sarılık gibi semptomları hızla iyileştirir. Komplikasyon riskini minimize etmek için deneyimli radyologlar tarafından uygun iğne seçimi ve görüntüleme rehberliği kritik önem taşımaktadır. Sonuç olarak girişimsel radyoloji, modern tıpta pankreas hastalıklarının yönetiminde cerrahiye alternatif veya tamamlayıcı, düşük morbiditeli ve yüksek etkili çözümler sağlamaktadır.
Interventional radiology provides minimal invasive methods for the diagnosis and treatment of pancreatic cancer, necrosis, pseudocysts, and vascular complications, thereby enhancing patient quality of life. During the diagnostic phase, percutaneous biopsies guided by USG or CT, particularly through the tru-cut biopsy method, reach accuracy rates of up to 95%. In managing fluid collections and pseudocysts developed after acute pancreatitis, percutaneous drainage is an effective option with an 80-90% success rate, reducing the need for surgery. In cases of pancreatic necrosis, closed methods such as percutaneous necrosectomy offer a safe alternative to the high mortality risks associated with open surgery. Furthermore, stenting and percutaneous transhepatic cholangioscopy procedures applied in biliary obstructions and pancreatic duct strictures rapidly improve symptoms like pain and jaundice by normalizing ductal pressure. To minimize the risk of complications, appropriate needle selection and imaging guidance by experienced radiologists are of critical importance. Consequently, interventional radiology provides low-morbidity and highly effective solutions as an alternative or complement to surgery in the management of pancreatic diseases in modern medicine.
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