无症状胰腺肿瘤38例临床分析

Clinical analysis of asymptomatic pancreatic tumors:a report of 38 cases

目的:总结无症状胰腺肿瘤的临床病理特点和诊治经验。方法:回顾性分析38例意外发现的无症状胰腺肿瘤的临床资料。结果:患者38例,男14例,女24例。年龄22～86岁,平均(50.2±16.2)岁。病程1d至7年。肿瘤位于胰头17例,胰体尾21例。所有患者均行手术切除,包括胰十二指肠切除术11例,保留十二指肠的胰头切除术3例,肿瘤局部切除术1例,节段性胰腺切除术8例,胰体尾、脾切除术15例。术后病理:胰腺导管癌5例,无功能胰岛细胞瘤13例(2例恶性),浆液性囊腺瘤8例,黏液性囊腺瘤8例,囊腺癌1例,恶性胰腺导管内乳头状黏液性肿瘤2例,胰腺实性假乳头状瘤1例。恶性肿瘤共10例,占26.3%(10/38)。随访表明,除3例胰体癌术后6个月死于肝转移外,其余患者已健康生存11个月至8年。结论:无症状胰腺肿瘤多为良性肿瘤,部分为恶性肿瘤,应积极手术治疗;手术切除率高,预后良好。

Objective ： To investigate the clinicopathological features,diagnosis and surgical treatment of asymtomatic pancreatic tumors. Methods： A retrospective clinical analysis was made in 38 patients with asymtomatic pancreatic tumors who were admitted from 1995 to 2004. Results： The patients included 14 men and 24 women with a mean age of 50.2 years （22-86 years） and a disease course of 1 d to 7 years. The masses were located in the head of pancreas in 17 patients and in body and tail in 21. Eleven patients were treated by pancreaticoduodenectomy, 3 by duodenum-preserving pancreatic head resection, 1 by local excision,8 by middle segment pancreatectomy,and 15 by distal pancreatectomy. The histologic type included nonfunctional insulinoma in 13, serous cystadenoma in 8. mucinous cystadenoma or cystadenoearcinoma in 9, malignant intraductal papillary mucinous tumor in 2, pancreatic solid-pseudopapilliary tumor in 1, and pancreatic ductal carcinoma in 5. Of all the patients, 10（26.3%） had malignant lesions. Conclusion.. It is suggested that most asymptomatic pancreatic tumors are benign lesions and surgical resection can be performed in most cases with favorable prognosis.