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目的探讨胰腺囊性肿瘤的诊断及外科治疗方法。方法对我院2003年4月至2012年4月期间收治的19例胰腺囊性肿瘤患者的临床资料进行回顾性分析。结果本组19例患者中浆液性囊腺瘤8例,黏液性囊腺瘤5例,导管内乳头状黏液瘤4例,实性假乳头状瘤1例,囊腺癌1例。行B超或CT发现胰腺占位病变。位于胰头部5例,胰体部8例,胰尾部6例。行肿瘤摘除术4例,保留脾脏的胰体尾切除术5例,胰体尾+脾脏切除手术3例,胰十二指肠切除术6例,1例囊腺癌患者因肝脏转移伴腹腔广泛转移、侵犯大血管而肿瘤不能切除仅行胃空肠、胆肠吻合。术后发生胰瘘2例,腹腔感染1例,经保守治疗后康复出院。无围手术期死亡病例。19例患者均进行了随访,随访时间6~80个月,平均45.2个月。1例囊腺癌合并肝脏转移患者于术后7个月死亡,其余良性肿瘤患者均未见复发,最长已存活5年。结论胰腺囊性肿瘤主要靠影像学检查发现,手术切除是理想的治疗方法,选择合适的术式有助于避免术后并发症的发生和改善预后。
Objective To investigate the diagnosis and surgical treatment of pancreatic cystic tumors. Methods The clinical data of 19 patients with pancreatic cystic tumors admitted to our hospital from April 2003 to April 2012 were analyzed retrospectively. Results In this group of 19 patients, there were 8 cases of serous cystadenoma, 5 cases of mucinous cystadenoma, 4 cases of intraductal papillary myxoma, 1 case of pseudopapillary solid tumor and 1 case of cystadenocarcinoma. Line B or CT found pancreas lesions. Located in the head of the pancreas in 5 cases, 8 cases of pancreatic body, tail in 6 cases. 4 cases of tumor resection, 5 cases of pancreatic body tail resection to retain the spleen, pancreatic body tail + splenectomy in 3 cases, pancreatoduodenectomy in 6 cases, 1 case of cystadenocarcinoma due to liver metastasis with extensive abdominal cavity Metastasis, invasion of large blood vessels and the tumor can not be removed only gastrointestinal jejunum, cholangioenterostomy. Postoperative pancreatic fistula occurred in 2 cases, 1 case of abdominal infection, after conservative treatment, discharged. No perioperative deaths. All the 19 patients were followed up for 6 to 80 months with an average of 45.2 months. One patient with cystadenocarcinoma and liver metastasis died at 7 months after operation. No recurrence was found in the other benign tumors, and the longest survived for 5 years. Conclusion Pancreatic cystic tumors mainly rely on imaging examination found that surgical resection is the ideal method of treatment, select the appropriate surgical procedures to help prevent postoperative complications and improve prognosis.