摘要
目的 总结胰腺浆液性肿瘤的诊断及治疗方法.方法 回顾性分析2008年1月-2012年10月本科收治的43例胰腺浆液性肿瘤病人的影像学和实验室检查、手术治疗方法、并发症及预后情况.结果 本组病人行腹部B超、胰腺增强CT、外周血肿瘤标记物检查,部分病人行MRI、内镜逆行胰胆管造影（endoscopic retrograde cholangiopancereatography,ERCP）和超声内镜（endoscopic ultrasonography,EUS）检查.肿瘤位于胰头部14例（32.6％）,胰腺体部21例（48.9％）,胰腺尾部8例（27.6％）;40例（93％）行手术治疗,3例（7％）经影像学检查确诊后定期复查.手术病人中行胰十二指肠切除术6例（15％）,胰腺体尾部切除术18例（45％）,胰腺中段切除术6例（15％）,胰腺肿瘤局部切除术10例（25％）.手术时间60～ 400 min,术中出血20 ～ 400ml,术后胰瘘8例（20％）,围手术期1例（2.5％）因术后腹腔大出血死亡,伤口感染1例（2.5％）,未出现腹腔感染及胃排空延迟并发症.术后病理诊断均为浆液性囊腺瘤.术后随访3～16个月,手术病人未出现复发及转移,行定期检查病人肿瘤较前无明显变化.结论 胰腺浆液性囊性肿瘤是一种少见的胰腺良性病变.通过腹部B超、CT及MRI检查与黏液性肿瘤做好鉴别,根据病变的情况选择合理的治疗方法.
Objective To summarize the diagnosis and treatment of pancreatic serous tumor.Methods Imaging and laboratory test data,surgical procedures,complications and prognosis of 43 patients with pancreatic serous tumor admitted to our hospital from January 2008 to October 2012 were retrospectively analyzed.Results Of the 43 patients,some underwent abdominal B ultrasound,pancreatic enhancement CT and peripheral blood tumor marker examination,some underwent MRI,ERCP and EUS.The tumor was located in pancreatic head,body and tail in 14 patients （32.6%）,21 patients （48.9%） and 8 patients （27.6%）,respectively.Of the 43 patients,40 （93%） underwent surgical operation and 3 （7%） diagnosed by image examination received regular reexamination,6 （15%） underwent pancreaticoduodenectomy,18 （45%） underwent pancreatic body and tail resection,6 （15%） underwent pancreatic middle resection.10 （25%） underwent local resection.The operation time was 60-400 min with an intra-operative blood loss of 20-400 ml.Pancreatic fistula was found in 8 patients （20%） after operation,1 patient （2.5%） died in perioperative period due to massive bleeding in abdominal cavity,wound infection occurred in 1 patient（2.5%）.No complications occurred such as abdominal infection and delayed gastric emptying.The patients were followed up for 3-16 months,during which no recurrence and metastasis were observed.Conclusion Pancreatic serous cystic tumor is a rare and benign lesion.Abdominal B ultrasound,CT and MRI can differentiate it from mucinous tumors.Rational treatment modalities should be selected according to the lesion situation.
出处
《解放军医学院学报》
CAS
2014年第6期529-532,共4页
Academic Journal of Chinese PLA Medical School
基金
全军医学科学技术研究"十二五"重大专项研究课题(CWS11J096)~~
关键词
胰腺浆液性肿瘤
外科手术
并发症
pancreatic serous neoplasm
surgical procedures, operative
complications
