胰腺囊性肿瘤临床诊治分析  

Analysis of Diagnosis and Treatment of Pancreatic Cystic Tumors

作　　者：王亚军[1] 李非[1] 孙家邦[1] 李昂[1] 曹锋[1] 方育[1] 李嘉[1] 贾建国[1] 陈宏[1] 杨鹏[1] 

机构地区：[1]首都医科大学宣武医院普外科,北京100053

出　　处：《中国普外基础与临床杂志》2012年第4期424-428,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨胰腺囊性肿瘤的诊治方法。方法回顾性分析29例胰腺囊性肿瘤患者的临床资料,包括一般资料、临床表现、辅助检查、手术方法、病理结果、术后并发症和随访结果。结果 8例(28%)浆液性囊性肿瘤(SCN),12例(41%)黏液性囊性肿瘤(MCN),3例(10%)导管内乳头状黏液肿瘤(IPMN),6例(21%)实性假乳头状肿瘤(SPT)。8例SCN、7例MCN、1例IPMN和5例SPT均是良性肿瘤。76%(22/29)患者是女性,年龄(49±17)岁(15～78岁)。29例中行手术治疗23例,其中切除肿瘤22例,探查活检1例,围手术期无死亡病例;另外6例未手术者中4例SCN者行随访观察处理,2例IPMN者拒绝手术治疗。29例患者中获随访21例,随访时间为(2.7±2.3)年(6个月～8年),失访8例。16例肿瘤切除者随访期内肿瘤无复发,1例探查活检者术后1年死亡;4例未手术的SCN患者随访期内肿瘤无明显增大。结论胰腺囊性肿瘤中最常见的是黏液性肿瘤和浆液性肿瘤,多见于女性;浆液性肿瘤均为良性,42%的黏液性肿瘤是恶性;误诊将延误治疗,增加死亡率。胰腺囊性肿瘤手术切除率高,根治性切除后预后好。Objective To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas.Methods Demographic data,clinical manifestations,diagnostic exams,surgical procedures,pathological diagnosis,postoperative complications,and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively.Results There were 8（28%） serous cystic tumors（SCN）,12（41%） mucinous cystic tumors（MCN）,3（10%） intraductal papillary mucinous tumors（IPMN）,and 6（21%） solid pseudopapillary tumors（SPT）.Eight cases of SCN,7 cases of MCN,1 case of IPMN,and 5 cases of SPT were all benign.The ages of the patients were from 15 to 78 years （average,（49±17） years） and all tumors were more common in female（76%,22/29）.Twenty-three cases of 29 patients were performed operations,22 cases were underwent surgical resection,and 1 case was performed exploration and biopsy.There was no surgery-related death.The rest 6 cases were not performed operation.Twenty-one cases followed-up for 6 months to 8 years（average,（2.7±2.3） years）,8 cases didn’t followed-up.Sixteen cases with surgical resection had no recurrence during follow-up period,1 case performed exploration and biopsy died in 1 year after operation,and 4 cases of SCN without surgery didn’t deteriorate.Conclusions The most common cystic neoplasms of pancreas are mucinous and serous cysts.These tumors are more frequent in female.Although almost all serous cysts are benign,42% of mucinous cysts are malignant.Misdiagnosis may delay appropriate treatment and increase mortality.The resection rate of pancreatic cystic tumor is high,and the prognosis is good after radical resection.

关 键 词：胰腺肿瘤 浆液性肿瘤 黏液性肿瘤 导管内乳头状瘤 实性假乳头状瘤 

分 类 号：R735.9[医药卫生—肿瘤]