胰腺实性假乳头状瘤的治疗:附17例报告  

The treatment of solid-peudopapillary tumors of pancreas:a report of 17 cases

作　　者：陈绍勤[1,2] 邹声泉[2] 李宏[2] 郑正荣[3] 张海云[4] 华进[1] 

机构地区：[1]福建医科大学附属第一医院胃肠外科,福建福州350005 [2]华中科技大学同济医学院附属同济医院胆胰外科,湖北武汉430030 [3]福建医科大学附属第二医院肿瘤外科,福建泉州362000 [4]福建省泉州市第一医院肿瘤外科,福建泉州362000

出　　处：《中国普通外科杂志》2009年第9期900-903,共4页China Journal of General Surgery

摘　　要：目的探讨CT检查和术中探查在胰腺实性假乳头肿瘤(SPTP)手术方式选择中的应用价值。方法回顾性分析10年间福建医科大学附属第一医院等4所医院手术所治17例SPTP患者的临床资料,分析术前CT判断、术中探查发现与术后病理学结果的关系。结果术前CT检查和术中探查能够较准确地判断肿瘤的大小、位置、侵袭生长情况;所有患者均接受了手术治疗,其中局部肿瘤切除术8例、胰尾切除术1例、胰体尾切除加脾切除术6例以及胰十二指肠切除术2例,17.6%的患者发生胰瘘等术后并发症,平均随访19.3个月未发现肿瘤复发。结论胰腺实性假乳头肿瘤手术切除率高,手术术式的选择应依据术前CT等影像检查和术中探查对肿瘤性质、大小、部位、包膜是否完整和是否侵及周围组织的判断,完整的肿瘤切除治疗能够获得良好预后。Objective To discuss the value of preoperative CT and intraoperative exploration in choice of surgical procedure for solid-pseudopapillary tumors of pancreas （SPTP）. Methods The clinical data of 17 eases of SPTP treated in the Affiliated First Hospital of Fujian Medical University and three other hospitals over the past 10 years were retrospectively analyzed. The relationship between the opinion from preoperative CT, the detection at intraoperative exploration and the postoperative pathological features were analyzed. Results Preoperative CT imaging and intraoperative exploration could accurately estimate the tumor＇s size, location and statas of invasion. All patients underwent surgical resection. Eight patients underwent local tumor resection, one underwent distal pancreatectomy, six had distal pancreatectomy with splenectomy, and pancreaticoduodenectomy was performed in the other two patients. Postoperative pancreatic fistula developed in 17.6 % of patients. The mean follow-up period was 19.3 months ; no recurrence was found. Conclusions The rate of resection in SPTP is high. The surgical approach should be based on the findings of pre-operative CT imaging and intraoperative exploration of the nature, size, location, capsular integrity of the tumor and infringement of surrounding tissue. Aggressive and complete resection of SPTP can result in good prognosis.

关 键 词：胰腺肿瘤/外科学 胰腺实性假乳头状瘤/治疗 预后 

分 类 号：R735.9[医药卫生—肿瘤]