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目的:探讨胰腺囊性占位的临床特点,评估手术治疗的结果。方法:回顾性分析2012年南京医科大学第一附属医院普外科收治的62例胰腺囊性占位患者的临床资料。结果:常见的胰腺囊性占位包括浆液性囊腺瘤(SCNs)、导管内乳头状黏液瘤(IPMNs)、黏液性囊腺瘤(MCNs)和胰腺假性囊肿。性别、年龄对IPMNs、MCNs和实性假乳头状瘤的诊断有意义。血清CEA升高对恶性囊性占位的诊断有意义。平均手术时间为(191±74)min,中位术中失血量200 ml,手术总体并发症为37.1%,胰瘘为最常见并发症(24.2%);再手术1例(1.6%),无死亡病例;术后住院中位时间11 d。保留器官胰腺切除手术与传统手术相比,在手术时间、术后并发症及住院时间方面无显著性差异,术中出血量显著减少。结论:临床特点和影像学特征有助于胰腺囊性占位诊断,保留器官的胰腺切除手术与传统手术同样安全。
Objective: To investigate the clinical features of pancreatic cystic mass and evaluate the results of surgical treatment. Methods: The clinical data of 62 patients with pancreatic cystic masses admitted to General Surgery, the First Affiliated Hospital of Nanjing Medical University in 2012 were retrospectively analyzed. Results: Common pancreatic cystic sites include serous cystadenomas (SCNs), intraductal papillary myxomas (IPMNs), mucinous cystadenomas (MCNs) and pancreatic pseudocysts. Gender and age are valuable for the diagnosis of IPMNs, MCNs and solid pseudopapillary tumors. Serum CEA increased the diagnosis of malignant cystic occupational significance. The average operation time was (191 ± 74) min. The median blood loss was 200 ml. The total operative complications were 37.1%. The most common complication was pancreatic fistula (24.2%). One case (1.6% Deaths; the median postoperative hospital stay was 11 days. There was no significant difference in operative time, postoperative complications and length of hospital stay between the conservative organ resection and conventional surgery, with a significant reduction of intraoperative bleeding. CONCLUSION: Clinical features and imaging features contribute to the diagnosis of cystic masses in the pancreas. Pancreatectomy with preserved organs is as safe as conventional surgery.