中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2009年
4期
288-291
,共4页
匡天涛%楼文晖%王单松%许雪峰%倪晓凌%吴文川%靳大勇
劻天濤%樓文暉%王單鬆%許雪峰%倪曉凌%吳文川%靳大勇
광천도%루문휘%왕단송%허설봉%예효릉%오문천%근대용
胰腺肿瘤%诊断%治疗%胰腺实性假乳头状瘤
胰腺腫瘤%診斷%治療%胰腺實性假乳頭狀瘤
이선종류%진단%치료%이선실성가유두상류
Pancreatic neoplasms%Diagnosis%Treatment%Solid pseudopapillary tumors of the pancreas
目的 总结胰腺实性假乳头状肿瘤的诊治及预后.方法 回顾性分析我院1999年1月至2008年4月手术切除的42例胰腺实性假乳头状肿瘤的临床特征、手术、病理情况及生存状况.结果 1999年1月至2008年4月我院共手术切除胰腺实性假乳头状肿瘤42例,其中,男性5例,女性37例;平均年龄37.6岁;胰头肿瘤18例,胰体尾24例;首发症状以腹痛最为多见(47.6%),28.6%患者无症状;MRI诊断正确率达93%(14/15);胰十二指肠切除10例,胰体尾加脾切除20例,肿瘤摘除术8例,保留脾胰体尾切除3例,节段胰腺切除1例;术后总并发症率38.1%,无再手术及围手术期死亡病例;肿瘤平均直径6.1 cm,34例实性肿瘤,6例为囊实性,2例为囊性;部分病例出现血管、神经侵犯;3例失访,其他均存活,平均随访时间38.6个月,其中4例术后出现肝转移,3例行介入栓塞治疗,1例行肝叶切除.结论 胰腺实性假乳头状肿瘤是一种好发于年青女性的低度恶性肿瘤,正规胰腺切除预后良好,应避免肿瘤摘除术;术后必须长期随访,如出现肝转移,采取介入栓塞或转移灶切除有较好的疗效.
目的 總結胰腺實性假乳頭狀腫瘤的診治及預後.方法 迴顧性分析我院1999年1月至2008年4月手術切除的42例胰腺實性假乳頭狀腫瘤的臨床特徵、手術、病理情況及生存狀況.結果 1999年1月至2008年4月我院共手術切除胰腺實性假乳頭狀腫瘤42例,其中,男性5例,女性37例;平均年齡37.6歲;胰頭腫瘤18例,胰體尾24例;首髮癥狀以腹痛最為多見(47.6%),28.6%患者無癥狀;MRI診斷正確率達93%(14/15);胰十二指腸切除10例,胰體尾加脾切除20例,腫瘤摘除術8例,保留脾胰體尾切除3例,節段胰腺切除1例;術後總併髮癥率38.1%,無再手術及圍手術期死亡病例;腫瘤平均直徑6.1 cm,34例實性腫瘤,6例為囊實性,2例為囊性;部分病例齣現血管、神經侵犯;3例失訪,其他均存活,平均隨訪時間38.6箇月,其中4例術後齣現肝轉移,3例行介入栓塞治療,1例行肝葉切除.結論 胰腺實性假乳頭狀腫瘤是一種好髮于年青女性的低度噁性腫瘤,正規胰腺切除預後良好,應避免腫瘤摘除術;術後必鬚長期隨訪,如齣現肝轉移,採取介入栓塞或轉移竈切除有較好的療效.
목적 총결이선실성가유두상종류적진치급예후.방법 회고성분석아원1999년1월지2008년4월수술절제적42례이선실성가유두상종류적림상특정、수술、병리정황급생존상황.결과 1999년1월지2008년4월아원공수술절제이선실성가유두상종류42례,기중,남성5례,녀성37례;평균년령37.6세;이두종류18례,이체미24례;수발증상이복통최위다견(47.6%),28.6%환자무증상;MRI진단정학솔체93%(14/15);이십이지장절제10례,이체미가비절제20례,종류적제술8례,보류비이체미절제3례,절단이선절제1례;술후총병발증솔38.1%,무재수술급위수술기사망병례;종류평균직경6.1 cm,34례실성종류,6례위낭실성,2례위낭성;부분병례출현혈관、신경침범;3례실방,기타균존활,평균수방시간38.6개월,기중4례술후출현간전이,3례행개입전새치료,1례행간협절제.결론 이선실성가유두상종류시일충호발우년청녀성적저도악성종류,정규이선절제예후량호,응피면종류적제술;술후필수장기수방,여출현간전이,채취개입전새혹전이조절제유교호적료효.
Objective To investigate the clinical features,diagnosis and prognosis of solid pseudopapillary tumor of the pancreas(SPTP). Method The clinical data of SPTP cases that underwent surgical resection with a definitive histological diagnosis in Zhong Shan Hospital from 1999 to 2007 were retrospectively analyzed.Result There were 42 SPTP cases undergoing surgery in this period,including 37 females and 5 males:mean age was 37.6 years.Tumors located in the pancreatic head in 18 cases and in the body or tail in 24 cases.The most common symptom was abdominal discomfort(n=20),palpable mass (n=8).Preoperative diagnostic accuracy of MRI and CT were 93%and 31.8%,respectively.Ten cases underwent pancreaticoduodenectomy,20 cases received distal pancreatectomy,3 cases did spleen-preserving distal pancreatectomy.Tumors were simply enucleated in 8 cases.Average diameter of the tumors was 6.1 cm,34 lesions were solid,6 were solid-cystic,2 were cystic.The overall perioperative morbidity was 38.1%,10 cases developed postoperative pancreatic fistula.The mean follow-up time was 38.6 months.Except three cases that were lost to follow-up,all the other cases were alive.Four cases(2 cases had had tumor enucleation,2 had had distal pancreatectomy)developed hepatic metastases on 70、110、41、3 months after first surgery,respectively.A transarterial chemoembolization was employed in three cases,while right hemihepatectomy was performed in one case. Conclusion SPTP is an indolent tumor with low-grade biological aggressiveness.Patients had a favorable outcome after surgical treatment,but enucleation should be avoided.Patients with liver metastasis may benefit from chemoembolization and liver resection.
