胰腺导管内乳头状黏液性肿瘤13例临床分析

Clinical analysis of intraductal papillary mucinous tumors of pancreas in 13 cases

目的总结胰腺导管内乳头状黏液性肿瘤(IPMT)的诊治经验,提高对该病治疗水平。方法自1985年5月至2004年3月共收治IPMT病人13例,男8例,女5例。所有病人均有不同程度的胰管扩张,8例进行了ERCP检查,发现胰管扩张,胰液溢出5例。结果除1人外,其他病人均接受了手术治疗,手术效果良好。术后病理诊断为胰头导管乳头状黏液性腺癌3例;胰头导管内乳头状黏液性腺瘤伴局部癌变2例;胰头导管内乳头状黏液性腺瘤伴不典型增生2例;胰头导管内乳头状黏液性腺瘤5例。结论IPMT与胰腺导管癌不同,ERCP有助于诊断本病,积极的手术治疗可获得良好的预后。

Objective To summarize the experience in diagnosis and treatment of intraductal papillary mucinous tumors （IPMT） of the pancreas. Methods A total of 13 patients with IPMT of the pancreas were treated in our hospital from May 1985 to March 2004. B-mode ultrasonography and CT scanning demonstrated different degrees of dilatation of the main pancreatic duct. ERCP was performed in 8 patients. Of the 8 patients, 5 had an abnormal protruding papilla of Vater with expulsion of mucous material. Results Amongst the 13 patients, 8 underwent pancreatoduodenectomy and 1 refused operation. Postoperative pathological examination showed intraductal papillary mucinous adenocarcinoma in 3 patients, intraductal papillary mucinous adenoma with partial cancerization in 2, intraductal papillary mucinous adenoma with atypical hyperplasia in 2 and intraductal papillary mutinous adenoma in 5. Conclusions IPMT is different from pancreatic ductal carcinoma. ERCP is helpful for its diagnosis. Resection is the most effective treatment and better prognosis can be achieved after operation.