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目的探讨CT检查和术中探查在胰腺实性假乳头肿瘤(SPTP)手术方式选择中的应用价值。方法回顾性分析10年间福建医科大学附属第一医院等4所医院手术所治17例SPTP患者的临床资料,分析术前CT判断、术中探查发现与术后病理学结果的关系。结果术前CT检查和术中探查能够较准确地判断肿瘤的大小、位置、侵袭生长情况;所有患者均接受了手术治疗,其中局部肿瘤切除术8例、胰尾切除术1例、胰体尾切除加脾切除术6例以及胰十二指肠切除术2例,17.6%的患者发生胰瘘等术后并发症,平均随访19.3个月未发现肿瘤复发。结论胰腺实性假乳头肿瘤手术切除率高,手术术式的选择应依据术前CT等影像检查和术中探查对肿瘤性质、大小、部位、包膜是否完整和是否侵及周围组织的判断,完整的肿瘤切除治疗能够获得良好预后。
Objective To investigate the value of CT and intraoperative exploration in the selection of operative methods for solid pseudobump tumor (SPTP) in the pancreas. Methods The clinical data of 17 cases of SPTP treated by 4 hospitals in the First Affiliated Hospital of Fujian Medical University during 10 years were retrospectively analyzed. The relationship between preoperative CT findings, intraoperative findings and postoperative pathological findings was analyzed. Results Preoperative CT examination and intraoperative exploration could accurately determine tumor size, location, invasion and growth; all patients underwent surgical treatment. Among them, partial tumor resection in 8 cases, pancreatic tail resection in 1 case, pancreatic body tail Resection and splenectomy in 6 cases and pancreatoduodenectomy in 2 cases, 17.6% of patients with pancreatic fistula and other complications occurred, the average follow-up of 19.3 months did not find tumor recurrence. Conclusion The surgical resection rate of solid pseudopapillary tumor of pancreas is high. The choice of surgical procedure should be based on the preoperative CT and other imaging and intraoperative exploration of tumor nature, size, location, the integrity of the capsule and whether the invasion of the surrounding tissue, Complete tumor resection treatment can get a good prognosis.