胃异位胰腺21例临床分析  

Clinical analysis on 21 cases with gastric heterotopic pancreas

作　　者：郑汝桦[1] 吕瑛[1] 王雷[1] 李运红[1] 张晓琦[1] 邹晓平[1] 

机构地区：[1]南京大学附属南京鼓楼医院消化科,南京210008

出　　处：《新医学》2015年第8期546-549,共4页Journal of New Medicine

摘　　要：目的探讨胃异位胰腺的内镜、超声内镜下特点及超声内镜诊断胃异位胰腺的价值。方法对经常规胃镜或超声内镜拟诊的30例胃异位胰腺病例进行回顾性分析。结果 30例患者均行内镜下黏膜下层剥离术(ESD),术后经病理确诊的胃异位胰腺21例,其余9例分别为胃黏膜慢性炎(3例)、脂肪瘤(2例)、印戒细胞癌(1例)、间质瘤(1例)、腺肌症(1例)、布氏腺增生(1例)。30例患者中有19例术前行超声内镜检查,其中13例术后确诊为异位胰腺,另6例病理为其他病变,超声内镜诊断胃异位胰腺的符合率为68.4%(13/19)。21例异位胰腺患者经随访均无并发症出现。结论超声内镜对诊断胃异位胰腺有一定的价值,但仍易与其他超声内镜下表现相似的病变混淆,胃镜及超声内镜下拟诊胃异位胰腺的,建议行内镜下切除进一步明确诊断,以免漏诊其他恶性病变。Objective To investigate clinical features of heterotopic pancreas（ HP） in the stomach under conventional endoscopy and endoscopic ultrasonography（ EUS）,and evaluate diagnostic value of EUS for gastric HP. Methods Clinical data of 30 patients suspected with gastric HP by gastroscopy or EUS were retrospectively analyzed. Results All 30 patients underwent endoscopic submucosal dissection（ ESD）. Postoperative histopathological results confirmed gastric HP in 21 patients,chronic gastritis in three,lipoma in two,signet-ring cell carcinoma in one,gastrointestinal stromal tumor（ GIST） in one,adenomyosis in one and adenoma of Brunner＇s glands in one patient. Among 30 individuals,19 underwent EUS examination before ESD,13 of whom histopathologically were confirmed with gastric HP and 6 with alternative lesions following ESD.The accuracy of EUS in the diagnosis of gastric HP was 68. 4%（ 13 /19）. Twenty one HP patients developed no postoperative complications during subsequent follow-up. Conclusions EUS has certain value in diagnosing HP in the stomach. However,EUS is likely to yield similar imaging findings to alternative ultrasound tests.HP-suspected cases detected by gastroscopy or EUS should undergo endoscopic resection to verify the diagnosis and avert missing the diagnosis of alternative malignancy.

关 键 词：异位胰腺 超声内镜 内镜下黏膜下层剥离术 

分 类 号：R657.5[医药卫生—外科学]