摘要
胰腺囊性肿瘤大部分为良性,部分为恶性或有恶变及转移潜能。术前肿瘤类型及良恶性的判断是决定治疗方案的关键因素,关于囊性肿瘤的手术时机和手术方法,国内外一直存有争论,尤其对于分支胰管型的导管内乳头状黏液腺瘤的处理争议最大。由于此类肿瘤少见,目前国际上仍无关于胰腺囊性肿瘤的基于循证医学的指南。对于浆液性囊腺瘤,因绝大部分为良性,极少数为低度恶性,应严格把握手术指征;对于黏液性囊腺瘤、主胰管型导管内乳头状黏液腺瘤、实性假乳头状瘤虽可为良性,但有恶性潜能或已恶变,应尽早手术切除;分支胰管型的导管内乳头状黏液腺瘤因对其恶变潜能及恶变的临界点不确定,手术及时机争论颇多。因胰腺囊性肿瘤谱从良性、不典型增生、原位癌至恶性分布不等,手术方式亦从较小的囊腺瘤剥除至胰十二指肠切除术不等。
Pancreatic cystic neoplasm（PCN） are a rare subset of pancreatie tumors , mostly benign, but some are malignant or with malignant transformation and metastatic potential. Preoperative judgement to benign or malignant types turns out to be key factors in determining treatments.About the operation timing and operation methods to PCN,there has been controversy at home and abroad, especially for branch duct type intraductal papillary mucinous neoplasm（BD-IPMN）. Due to the low incidence of PCN, currently there is still no international evidence based guidelines. For serous cysticneoplasm（SCN）,the vast majority of them are benign,operation should be very cautious;for mucinous cystic neoplasm（MCN）, main duct type intraductal papillary mucinous neoplasm （MD-IPMN） and solid pseudopapillary neoplasm（SPT）,most of them are benign,but are believed to have malignant transformation potential or have been malignant,should be resected as soon as possible;for BD-IPMN, it is still controversy to it＇ s malignant transformation potential and is hard to judge the cut-off point,so operation and timing is the hot point to discuss.As the PCN＇ s spectrum ranges from benign,PanIN,carcinoma in situ to malignancy,the operational methods range from enuleation to pancreaticoduodenectomy.
出处
《中国实用外科杂志》
CSCD
北大核心
2013年第6期457-460,共4页
Chinese Journal of Practical Surgery
关键词
胰腺
囊性肿瘤
外科治疗
pancrea
cystic neoplasms
surgical therapy
