十二指肠良性肿瘤的手术治疗  

Surgical management of benign duodenum tumors

作　　者：严佶祺[1] 彭承宏[1] 杨卫平[1] 丁家增[1] 周光文[1] 陈拥军[1] 金筱泰[1] 李宏为[1] 

机构地区：[1]上海交通大学医学院瑞金医院外科,上海200025

出　　处：《上海交通大学学报（医学版）》2008年第12期1575-1576,1583,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨十二指肠良性肿瘤的诊断和治疗方法。方法回顾性分析18例经病理证实的十二指肠良性肿瘤的临床资料，包括临床症状、诊断方法、病灶部位、手术方式、病理结果和预后等。结果18例患者均行手术切除治疗，其中8例行局部切除术，1例行肠段切除术，1例行胃大部切除术，3例行乳头部肿瘤切除加括约肌成形术，5例行胰十二指肠切除术；病理检查证实腺瘤5例、管状腺瘤2例、绒毛状腺瘤2例、管状绒毛状腺瘤2例、错构瘤2例、错构瘤性息肉1例、Brunner腺瘤1例、腺肌瘤1例、纤维瘤病1例、异位胰腺1例；经2～60个月随访，1例死于非相关疾病，1例失访，其余生活质量良好。结论上腹部不适和上消化道出血是十二指肠良性肿瘤最为常见的症状，手术切除是首选的治疗方法，且预后良好。Objective To investigate the diagnosis and treatment of benign duodenal tumors. Methods The clinical data of 18 patients with benign duodenum tumors confirmed by pathology were retrospectively analyzed, including the clinical symptoms, diagnostic methods, tumor locations, surgical approaches, pathological results and prognosis, etc. Results All the 18 patients underwent surgical resections, among whom 8 with local resection, 1 with segmental duodenectomy, 1 with gastrectomy, 3 with tumor resection of papilla and sphincteroplasty, and 5 with pancreaticoduodenectomy. It was revealed by pathological examinations that adenoma was found in 5 patients, tubular adenoma in 2, villous adenoma in 2, tubulovillous adenoma in 2, hamartoma in 2, hamartomatous polyp in l, Brunner＇s adenoma in 1, adenomyoma in 1, fibromatosis in 1 and ectopic pancreas in the remaining one. During the follow-up for 2 to 60 months, one died of non- related disease, one lost in follow-up, and the remaining survived with a good quality of life. Conclusion Upper abdominal discomfort and upper gastrointestinal hemorrhage are common symptoms of patient with benign duodenum tumors. Surgical resection is the best choice for treatment with satisfactory prognosis.

关 键 词：十二指肠肿瘤 括约肌成形 胰十二指肠切除 

分 类 号：R735.3[医药卫生—肿瘤]