目的 探討胰腺囊性腫瘤的診斷及外科治療方法。
方法 對(duì)我院2003年4月至2012年4月期間收治的19例胰腺囊性腫瘤患者的臨床資料進(jìn)行回顧性分析。
結(jié)果 本組19例患者中漿液性囊腺瘤8例,黏液性囊腺瘤5例,導(dǎo)管內(nèi)乳頭狀黏液瘤4例,實(shí)性假乳頭狀瘤1例,囊腺癌1例。行B超或CT發(fā)現(xiàn)胰腺占位病變。位于胰頭部5例,胰體部8例,胰尾部6例。行腫瘤摘除術(shù)4例,保留脾臟的胰體尾切除術(shù)5例,胰體尾+脾臟切除手術(shù)3例,胰十二指腸切除術(shù)6例,1例囊腺癌患者因肝臟轉(zhuǎn)移伴腹腔廣泛轉(zhuǎn)移、侵犯大血管而腫瘤不能切除僅行胃空腸、膽腸吻合。術(shù)后發(fā)生胰瘺2例,腹腔感染1例,經(jīng)保守治療后康復(fù)出院。無圍手術(shù)期死亡病例。19例患者均進(jìn)行了隨訪,隨訪時(shí)間6~80個(gè)月,平均45.2個(gè)月。1例囊腺癌合并肝臟轉(zhuǎn)移患者于術(shù)后7個(gè)月死亡,其余良性腫瘤患者均未見復(fù)發(fā),最長已存活5年。
結(jié)論 胰腺囊性腫瘤主要靠影像學(xué)檢查發(fā)現(xiàn),手術(shù)切除是理想的治療方法,選擇合適的術(shù)式有助于避免術(shù)后并發(fā)癥的發(fā)生和改善預(yù)后。
引用本文: 郝建朋,姚俊超,郭大偉,孫文郁,梁健,姜曉峰. 胰腺囊性腫瘤19例診治分析. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(11): 1295-1297. doi: 復(fù)制
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2. | Farrell JJ, Fernández-del Castillo C. Pancreatic cystic neoplasms:management and unanswered questions[J]. Gastroenterology, 2013, 144(6):1303-1315. |
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6. | Lee SE, Kwon Y, Jang JY, et al. The morphological classification of a serous cystic tumor (SCT) of the pancreas and evaluation of the preoperative diagnostic accuracy of computed tomography[J]. Ann Surg Oncol, 2008, 15(8):2089-2095. |
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8. | Tanaka M. Intraductal papillary mucinous neoplasm of the panc-reas:diagnosis and treatment[J]. Pancreas, 2004, 28(3):282-288. |
9. | Kim YI, Woo SM, Lee WJ, et al. Appropriate indications of initialendoscopic ultrasound evaluation for detecting mural nodules in branch duct intraductal papillary mucinous neoplasms of the panc-reas[J]. Scand J Gastroenterol, 2013, 48(5):610-616. |
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11. | Al-Rashdan A, Schmidt CM, Al-Haddad M, et al. Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience[J]. J Gastrointest Oncol, 2011, 2(4):208-214. |
12. | Beger HG, Siech M, Poch B. Duodenum-preserving total panc-reatic head resection:an organ-sparing operation technique for cystic neoplasms and non-invasive malignant tumors[J]. Chirurg,. |
13. | Atiq M, Suzuki R, Khan AS, et al. Clinical decision making in the management of pancreatic cystic neoplasms[J]. Expert Rev Gastroenterol Hepatol, 2013, 7(4):353-360. |
14. | Konstantinou F, Syrigos KN, Saif MW. Intraductal papillary mucinous neoplasms of the pancreas (IPMNs):epidemiology, diagnosis and future aspects[J]. JOP, 2013, 14(2):141-144. |
15. | Gálvez E, Gálvez G, Barboza A, et al. Pancreatic intraductal papillary mucinous neoplasm and recurrent pancreatitis[J]. Rev Gastroenterol Peru, 2013, 33(1):66-74. |
16. | , 84(5):412-420. |
- 1. Mori E, Yuen K, Medrano H, et al. Management of pancreatic cystic tumors in the Alberto Sabogal Sologuren hospital[J]. Rev Gastroenterol Peru, 2012, 32(2):169-177.
- 2. Farrell JJ, Fernández-del Castillo C. Pancreatic cystic neoplasms:management and unanswered questions[J]. Gastroenterology, 2013, 144(6):1303-1315.
- 3. de Jong K, van Hooft JE, Nio CY, et al. Accuracy of preoperative workup in a prospective series of surgically resected cystic pancreatic lesions[J]. Scand J Gastroenterol, 2012, 47(8-9):1056-1063.
- 4. Lee LS, Clancy T, Kadiyala V, et al. Interdisciplinary management of cystic neoplasms of the pancreas[J]. Gastroenterol Res Pract, 2012. doi:10. 1155/2012/513163.
- 5. Scoazec JY, Vullierme MP, Barthet M, et al. Cystic and ductal tumors of the pancreas:diagnosis and management[J]. J Visc Surg, 2013, 150(2):69-84.
- 6. Lee SE, Kwon Y, Jang JY, et al. The morphological classification of a serous cystic tumor (SCT) of the pancreas and evaluation of the preoperative diagnostic accuracy of computed tomography[J]. Ann Surg Oncol, 2008, 15(8):2089-2095.
- 7. Curry CA, Eng J, Horton KM, et al. CT of primary cystic panc-reatic neoplasms:can CT be used for patient triage and treatment?[J]. AJR Am J Roentgenol, 2000, 175(1):99-103.
- 8. Tanaka M. Intraductal papillary mucinous neoplasm of the panc-reas:diagnosis and treatment[J]. Pancreas, 2004, 28(3):282-288.
- 9. Kim YI, Woo SM, Lee WJ, et al. Appropriate indications of initialendoscopic ultrasound evaluation for detecting mural nodules in branch duct intraductal papillary mucinous neoplasms of the panc-reas[J]. Scand J Gastroenterol, 2013, 48(5):610-616.
- 10. Wang DB, Wang QB, Chai WM, et al. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography[J]. World J Gastroenterol, 2009, 15(7):829-835.
- 11. Al-Rashdan A, Schmidt CM, Al-Haddad M, et al. Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience[J]. J Gastrointest Oncol, 2011, 2(4):208-214.
- 12. Beger HG, Siech M, Poch B. Duodenum-preserving total panc-reatic head resection:an organ-sparing operation technique for cystic neoplasms and non-invasive malignant tumors[J]. Chirurg,.
- 13. Atiq M, Suzuki R, Khan AS, et al. Clinical decision making in the management of pancreatic cystic neoplasms[J]. Expert Rev Gastroenterol Hepatol, 2013, 7(4):353-360.
- 14. Konstantinou F, Syrigos KN, Saif MW. Intraductal papillary mucinous neoplasms of the pancreas (IPMNs):epidemiology, diagnosis and future aspects[J]. JOP, 2013, 14(2):141-144.
- 15. Gálvez E, Gálvez G, Barboza A, et al. Pancreatic intraductal papillary mucinous neoplasm and recurrent pancreatitis[J]. Rev Gastroenterol Peru, 2013, 33(1):66-74.
- 16. , 84(5):412-420.