摘要
目的探讨胰腺囊性肿瘤的临床诊断策略、手术时机和方法以及并发症的处理。方法选择本院2002年1月～2012年5月共确诊收治胰腺囊性肿瘤患者15例,根据术前辅助检查确定的肿瘤部位、性质、大小采取不同的手术方式,并对患者预后和并发症进行分析。结果术前B超和CT确诊率分别为66.7%和80.0%。经病理确诊黏液性囊腺瘤6例、浆液性囊腺瘤4例、囊腺癌2例、导管内乳头状黏液性肿瘤3例。15例患者均接受手术治疗,且术中无死亡病例,其中3患者接受保留十二指肠的胰头切除术,5例患者接受胰十二指肠切除术,4例患者接受胰腺体尾部切除术,1例患者接受胰腺节段切除术,2例患者接受胰腺全切治疗。术后1例患者出现胃瘫,3例患者发生胰漏,经对症治疗后均或缓解,所有患者均康复出院,且均获随访,随访率100%,时间7个月～8年,平均3.3年,仅1例患者术后19个月复发死亡。结论胰腺囊性肿瘤临床表现不明显,对病理类型术前难以确诊,及时采取手术治疗仍是最为有效的治疗手段,但应遵循个体化的原则,选择合理术式,降低并发症的发生。
Objective To investigate the clinical diagnosis tacties, timing and method of operation and treatment of complications of cystic neoplasms of the pancreas. Methods 15 patients with cystic neoplasms of the pancreas of our hospital from January 2002 to May 2012 were given different surgical approach according to tumor location, nature and size detected b）, preoperative laboratory examinations, the prognosis and complications were analyzed. Results The diagnosis rate of B ultrasound and CT was 66.7% and 80.0% respectively. There were 6 cases of mucinous neoplasm（MCN）,5 cases of serous cystic neoplasm（SCN）, 2 cases of intraductal papillary mutinous neoplasm（IPMN） and 2 cases of solid pesudopapillary neoplasms（SPTP） confirmed by pathology. 15 patients were all given surgical treatment and no intraoperative deaths, 3 patients were accepted duodenum-preserving pancreatic head resection, 5 patients were accepted pancreato-duodenectomy, 4 patients were accepted distal pancrectomy, 1 patients were accepted middle segment resection and 2 patients were accepted panereatectomy. There were 1 case of gastroparesis and 3 cases of pancreatic leakage, and all the patients were discharged. All the patients were followed-up （100%）, for 7 months to 8 years and with an average time for 3.3 years, and there was 1 patient died 19 months after operation because of tunlor recurrence. Conclusion There is no specific clinical manifestations for cystic neoplasms of the pancreas to get an accurate preoperative pathological diagnosis, for now, timely surgery is still the most effective treatment, however, it should follow the principle of individual and select a reasonable procedure to reduce the incidence of complications.
出处
《中国医药科学》
2013年第7期68-69,79,共3页
China Medicine And Pharmacy
关键词
胰腺
囊性肿瘤
诊断
手术治疗
并发症
Pancreas
Cystic tumor
Diagnosis
Surgical treatment
Complications
