胰腺囊性肿瘤的诊断与治疗  

Diagnosis and treatment of pancreatic cystic neoplasms

作　　者：王会元[1] 杨尹默[1] 庄岩[1] 陈焕年[1] 万远廉[1] 黄莛庭[1] 

机构地区：[1]北京大学第一医院外科,北京市100034

出　　处：《中华肝胆外科杂志》2006年第11期738-741,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨胰腺囊性肿瘤的诊断与外科治疗。方法回顾性研究北京大学第一医院外科1994-2004年所收治45例胰腺囊性肿瘤的临床资料。结果本组病例涉及8种不同囊性肿瘤,男12例,女33例,平均年龄49．1岁,临床表现无特异性。B超及CT检查提示囊性或囊实性占位, ERCP、EUS等可提供鉴别诊断线索。根据肿瘤位置及性状选择局部切除术13例,Whipple术12例,胰体尾切除术18例,全胰腺切除术1例,单纯活检术1例。无围手术期死亡,术后胰瘘2例经保守治疗痊愈。随访38例,平均32．6个月。随访期内死亡4例,其中3例死于肿瘤复发,其余病人无瘤生存。结论胰腺囊性肿瘤包括多种亚型,临床表现均无特异性,诊断须综合各项检查结果,诊断明确者应积极手术治疗,切除率高,预后较好。Objective To summarize the experience in diagnosis and treatment of pancreatic cystic neoplasms. Methods The clinical data of 45 patients with pancreatic cystic neoplasms treated in our hospital from 1994 to 2004 were retrospectively analyzed. Results Of the 45 patients with an average of 49.1 years, 12 were male and 33 female. The tumors could be divided into 8 subtypes. The clinical manifestations showed no specificity. Cystic masses or cystic solid masses were found in the pancreas by ultrasonography and CT scanning. ERCP and EUS had additional value for the differentiation of cystic tumors. Local resection of tumors, Whipple procedure and distal pancreatectomy were performed in 13, 12 and 18 patients, respectively, in accordance with the tumor location and pathological features. One patient underwent total pancreatectomy and another biopsy alone. No patient died within the perioperative period. Pancreatic fistula occurred in 2 patients and it was cured by conservative management. Thirty-eight patients were followed up for an average of 32. 6 months. During the follow-up period, only 4 patients died and the others survived without relapse and metastasis. Conclusions Since there exists various pancreatic cystic neoplasms without specific symptoms, different kinds of examinations are needed to diagnose the disease. Prompt surgery is recommended for the tumors. The rate of surgical resection in high and the prognosis is satisfactory.

关 键 词：胰腺囊肿 囊性肿瘤 

分 类 号：R735.9[医药卫生—肿瘤]