原发性十二指肠肿瘤诊治8例  

Experience in diagnosis and treatment for 8 cases of primary duodenal tumor

作　　者：张宗明 李刚 高原[2] 邢海林[2] 朱建平 宿砚明 钟华 郭金星 杨俊雄 

机构地区：[1]清华大学第一附属医院消化中心普外科,北京市100016 [2]同济大学附属同济医院普外一科,上海市200065

出　　处：《世界华人消化杂志》2006年第13期1330-1332,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨原发性十二指肠乳头、降部、水平部良恶性肿瘤的诊断和手术方式选择,提高诊治水平和疗效.方法:对2001-09/2005-10收治的8例原发性十二指肠乳头、降部、水平部肿瘤的诊断和手术方式进行回顾性分析.术前行B超、CT、十二指肠低张造影、十二指肠镜检查,发现乳头肿瘤3例,降部肿瘤2例,水平部肿瘤3例.结果:确诊原发性十二指肠乳头管状腺瘤及间质瘤并行肿瘤局部切除术各1例,中高分化腺癌行胰十二指肠切除术1例;原发性十二指肠降部中及低分化腺癌行胰十二指肠切除术各1例;原发性十二指肠水平部间质瘤行局部肠段切除术2例,中高分化腺癌行胰十二指肠切除术1例.所有病例术后恢复良好,无手术并发症.随访时间29.1±19.7(3-51)mo,均健康生存.结论:对于原发性十二指肠乳头和降部良性肿瘤,以CT结合十二指肠镜检查和局部肿瘤切除为主要诊断手段和术式选择;对于原发性十二指肠水平部良性肿瘤,首选十二指肠低张造影检查和局部肠段切除治疗;对于原发性十二指肠乳头、降部或水平部恶性肿瘤,均应首选胰十二指肠切除术.AIM： To evaluate the preoperative diagnostic and surgical procedures for primary tumor of the duodenum （PTD）. METHODS： A retrospective analysis was performed on 8 PTD patients admitted in our hospital from October 2001 to December 2004. B-ultrasound, computed tomography （CT）, duodenal endoscopy and air barium double radiography were used in the diagnosis of PTD located in the descending portion （2 cases）, papilla region （3 cases） and inferior part （3 cases） of the duodenum. RESULTS： For papilla region of the duodenum, 1 case of tubular adenoma and 1 leiomyoma were treated with the local resection of tumor, and 1 case of well/moderately-differentiated carcinoma underwent the pancreatoduodenectomy. For the descending portion of the duodenum, 1 case of moderately-differentiated and 1 poorly-differentiated carcinoma received pancreatoduodenectomy. For inferior part of the duodenum, 2 cases of leiomyoma were given the local segmental resection of the duodenum, and 1 case of moderately-differentiated carcinoma underwent pancreatoduodenectomy. All the patients got smooth recovery from the operation, and no complications occurred. All the patients survived healthily, with the follow-up period of 29.7 ± 19.7 mo （3 to 51 too）. CONCLUSION： For the PTD located in the papilla region and descending portion, CT and duodenal endoscopy are main methods for the preoperative diagnosis, and local resection are ideal surgical procedures. For the benign PTD in the inferior part, air barium double radiography is the first choice for the diagnosis, and segmental duodenectomy are curable. For the malignant PTD in the papilla region, descending portion and inferior part, the therapeutic choice should be pancreatoduodenectomy.

关 键 词：原发性十二指肠肿瘤 诊断 胰十二指肠切除术 十二指肠节段切除:局部切除 

分 类 号：R735.31[医药卫生—肿瘤] R587.1[医药卫生—临床医学]