原发性十二指肠肿瘤43例诊治分析

The diagnosis and treatment of primary duodenal tumor

目的 探讨原发性十二指肠肿瘤 (PTD)的诊断和治疗。方法 回顾性分析我院 1995 2 0 0 3年间 4 3例PTD的临床资料。结果 十二指肠镜确诊率为 85 .7% ,B超检查的阳性率为 5 5 .6 % ,CT检查阳性率为 80 % ,肿瘤位于十二指肠降段 (乳头部或其对侧 ) 35例 ,占 81.4 % ,2例平滑肌瘤切除术后存活 5年以上 ,1例乳头部腺瘤行肿瘤局部切除术后半年出现黄疸 ,病因不详。 4例间质瘤均健在且生存 16 2 1个月 ,36例原发性十二指肠恶性肿瘤中胰头十二指肠切除 18例 ,节段切除 1例 ,手术切除率为 5 1.2 %。结论 B超、CT、纤维十二指肠镜检查是诊断PTD的主要手段。手术切除是最基本有效的治疗方法。对于良性肿瘤可行局部肿瘤切除、十二指肠节段切除或经内镜切除。对于恶性肿瘤 ,胰十二指肠切除术是首选术式。

Objective To evaluate the diagnosis and treatment of primary tumor of the duodenum(PTD). Method The clinical data of 43 cases with PTD in the last 9 years were analyzed retrospectively. Result The corret diagnostic rate of auxiliary examination were: duodenal endoscopy of 85.7%, BUS of 55.6%, CT of 80.0%; The most common location of the tumors (81.4%) was at the second portion of the duodenum; 2 benign PTDs with a 5 year's survival of 100%, 1 adenomal carcinorma with local resection was objective jaundice after half year again, reason unknown . 4 cases of duodenal mesenchymal tumor have survived 16~21 months, 18 cases in 36 malignant PTDs underwent pancreatoduodenectomy, 1 case received segmental duodenectomy, the resection rate was 51.2%. Conclusion BUS、CT、duodenal endoscopy are the main methods for the diagnosis of PTD. Segmental duodectomy and local resection are curable for benign PTD, while for malignant PTD the best therapy should be pancreaticoduodenectomy.