16例小儿胰腺囊肿的诊断和治疗

Diagnosis and treatment of 16 children with cystic lesions in the pancreas

目的分析小儿胰腺囊肿的诊断和治疗。方法本组 16例胰腺囊肿患儿 ,12例有腹部外伤史 ,3例有腹痛等炎症表现 ,1例胆总管囊肿切除术后反复腹痛。B超或CT证实胰腺有囊肿样改变。 11例行囊肿外引流术 ,4例行囊肿—空肠Roux Y吻合术 ,1例因病理证实为胰腺实体—囊性假乳头状瘤而行囊肿和脾切除以及脾自体移植术。结果 16例胰腺囊肿中 ,治愈 15例 ,1例因合并伤死亡。无胰瘘发生 ,B超或CT随访无囊肿或肿瘤复发。结论腹部外伤是胰腺囊肿形成的最主要原因 ;B超和CT检查为主要诊断手段 ;囊肿外引流术可作为早期控制症状的手术选择。

Objective To analyse the diagnosis and treatment of cystic lesions of the pancreas. Methods In 16 children with cystic lesions of the pancreas, 12 had traumatic history, 3 had inflammatory history, and 1 had abdominal pain after Roux-Y surgery in a local hospital. The lesions were identified by ultrasound and CT scan. All children undergone operation, 11 with external drainage, 4 with cystojejunostomy and 1 with distal pancreatectomy and spleen resection with spleen self-transplantation. Results Fifteen cases were cured and 1 died due to severe trauma. No pancreatic fistula and abscess occured in these sixteen cases. Recurrence of tumor or cyst has not been found by ultrasound or CT examination. Conclusion Trauma of abdomen is the main cause of the cystic lesion of the pancreas in children. Accurate diagnosis could be made by ultrasound and CT examination. External drainage in early stage could be choice when conservative treatment is unsatisfied or failed.