胰头占位性病变专题讨论  

Panel discussion on the space-occupying lesions of the head of pancreas

作　　者：王春友[1] 孙备[2] 陈华[2] 金震东[3] 侯晓佳[3] 阎晓初[4] 张太平[5] 楼文晖[6] 张琨[7] 叶慧义[7] 董家鸿[8] 苗毅 刘续宝[10] 梁力建[11] 别平[12] 张雷达[12] 姜洪池[13] 林汉[13] 刘正才[14] 窦科峰[14] 孙诚谊[15] 

机构地区：[1]华中科技大学同济医学院附属协和医院胰腺病研究所,武汉430022 [2]哈尔滨医科大学附属第一医院胰胆外科,150001 [3]第二军医大学附属长海医院消化科,上海200433 [4]第三军医大学西南医院病理学研究所,重庆400038 [5]中国医学科学院北京协和医院基本外科,100730 [6]复旦大学附属中山医院普通外科,上海200032 [7]解放军总医院影像中心,北京100853 [8]解放军总医院肝胆外科医院 全军肝胆外科研究所,北京100853 [9]南京医科大学第一附属医院胰腺中心,210029 [10]四川大学华西医院胰腺外科,成都610041 [11]中山大学附属第一医院肝胆外科,广州510080 [12]第三军医大学西南医院全军肝胆外科研究所、中国人民解放军西南肝胆外科医院,重庆400038 [13]哈尔滨医科大学附属第一医院消化病医院肝脾外科中心,150001 [14]第四军医大学西京医院肝胆胰脾外科,西安710032 [15]贵阳医学院附属医院肝胆外科 贵州省肝胆胰脾疾病研究所,550004

出　　处：《中华消化外科杂志》2014年第11期841-851,共11页Chinese Journal of Digestive Surgery

摘　　要：胰头占位包括肿瘤性及炎性病变,虽然目前影像学检查手段日趋丰富,但不典型患者术前仍难以鉴别;通过术前、术中各种途径的活组织检查以获取病理诊断是可行之举,但具有局限性,有假阴性可能;针对此问题国内外虽有多篇指南和共识发表,但指导性及可操作性不强;胰十二指肠切除术过程复杂,术后有较高的并发症发生率.基于此,对于不典型患者或术前影像学检查难以排除恶性诊断而活组织病理检查为阴性的患者,如何决策治疗方式,仍是困扰外科医师的现实问题.针对上述问题,《中华消化外科杂志》编辑部组织国内相关学科的专家就个人经验提出见解,展开专题学术讨论.The space-occupying lesions of the head of pancreas include the cancerous and inflammatory lesions.Currently,it is still difficult to detect the atypical lesions in patients before surgery through various imaging examinations that have been popular.Pathological diagnosis by preoperative and intraoperative biopsy is effective and feasible,but false negative findings are potential limitations of this method.While many guideline and consensus papers have been published in China and aboard,so far,the clinical guiding and feasibility of the documents are unsatisfactory.In particular,patients are at high risk of postoperative complications after a complex pancreaticoduodenectomy.It is still the key point for surgeons to determine treatment regimens for patients with atypical symptoms or unproved malignant tumor by preoperative imaging examination and negative biopsy.Therefore,15 experts in relevant fields from China were invited to present their opinion based on their personal clinical experiences during a panel discussion on the space-occupying lesions of the pancreas head.

关 键 词：胰头占位性病变 病理诊断 治疗 多学科团队 

分 类 号：R735.9[医药卫生—肿瘤]