摘要
胰管结石合井胰腺癌是较少见的疾病，术前不易确诊。本组５例中术前确诊仅２例，占该院同期收治胰管结石病例的１７．２％。其临床特点是：①男性多见；②有慢性酒精性胰腺炎病史，并发糖尿病亦多见；③病程较长，主要表现为上腹持续疼痛，顽固背心痛，纳差，腹泻，消瘦，发生黄疽者较少。诊断时应注意：①对有胰管结石患者，当其慢性胰腺炎症状短期内持续加重，伴纳差、消瘦明显时，应警惕合并胰腺癌的可能性；②应采用多种影像学和肿瘤标记物如ＣＡ１９－９、ＣＥＡ、乳铁蛋白检查，有助诊断；③术中细致探查，对可疑结节应作冰冻活检。
Pancreolith with pancreatic carcinoma is a rare disease. It's difficult to be diagnosed before operation. In this study we summerized 29 cases of pancreolith (including cases of pancreolith with pancreatic carcinoma )during Jan.1989 to Oct. 1994 treated in our hospital. The clinical characteristics were the following more male patients encomtered; many had the history of chronic alcoholic pancreatitis and many accompanied with diabetes;the main symptoms were persistent upper abdominal pain,pain in the back anoxia,diarrhea,wasting,but rarely jaundice. Main points in diagnosis: ①When the symptoms of chronic pancreatitis are getting worse and the patients become wasting,the carcinoma should be considered. ②Mutiple investigations such as B-US, CT, and MRI, CA19-9, CEA should be taken. ③Exploretory laparotomy and freezy biopsy is performed if nesscessery. Two patients were diagnosed before operation in this study. 3 cases had pancreatoduodenectomy. One had biopsy and other had pancreatojejunostomy.
