摘要
目的探讨胰腺囊性病变的外科手术指征及诊治方法。方法对2010年10月至2015年10月四川大学华西医院胰腺外科收治的341例胰腺囊性病变进行梳理,排除术前诊断明确的278例,针对术前诊断存疑的63例临床资料进行回顾性分析。结果胰腺囊性病变外科手术指征为:病变大于4 cm;影像学提示恶性征象;合并明显临床症状不能用其他疾病解释;无症状胰腺囊性病变,病变中密度杂乱,或主胰管明显扩张,无手术高危因素。随访提示病情进展者行外科根治性手术。超声内镜引导下细针穿刺结果是提高诊断准确性的重要补充,但现阶段诊断效能不佳。结论病变直径、影像学诊断存疑、腹痛或重度腹部不适、梗阻性黄疸、血清肿瘤标志物异常等因素,是胰腺囊性病变手术指征的考虑因素。
Objective To explore the surgical indication, diagnosis and treatment of suspected pancreatic cystic lesions. Methods To- tally 341 patients were admitted into our hospital because of pancreatic cystic lesions from October 2010 to October 2015. Except the 278 confirmed cases, the clinical data of the rest 63 patients with vague diagnosis were retrospectively analyzed. Results The surgical indication of pancreatic cystic lesions were： the lesion diameter was more than 4 cm; the imaging diagnosis was malignant; the lesion was combined with obvious clinical symptoms which can not explain with other diseases; there were asymptomatic pancreatic cystic lesion and main pancre- atic duct dilation without surgical risk factors; the follow-up showed that the desease is in development. Endoscopic uhrasonography guided fine needle aspiration is a useful supplement for more accurate diagnosis. However, it is an uncertain diagnostic value currently. Conclusion Diameter of lesion, uncertain imaging diagnosis, severe abdominal symptoms, obstructive jaundice and abnormal serum tumor markers are the surgical indication for patients.
出处
《局解手术学杂志》
2016年第10期735-738,共4页
Journal of Regional Anatomy and Operative Surgery
基金
四川省科学技术厅支撑计划项目(2012SZ0141)
关键词
胰腺囊性病变
诊断
手术指征
pancreatic cystic lesions
diagnosis
surgical indication
