胰腺巨大囊性实质性肿瘤的诊断和治疗

Diagnosis and treatment of huge cystic and solid tumor of pancreas

目的探讨胰腺巨大囊性实质性肿瘤术前有效的诊断和外科治疗方法。方法回顾性总结分析巨大胰腺囊性实质性肿瘤(直径>8cm)的术前诊断方法和手术治疗结果。结果复旦大学华山医院外科自1999年至今收治15例直径>8cm的胰腺囊性实质性肿瘤,均行根治性手术切除。病理诊断:实性假乳头状瘤9例,囊腺瘤4例,囊腺癌2例。结论胰腺巨大囊性实质性肿瘤的诊治较为困难,螺旋CT、DSA结合肿瘤标记物检测有助于肿瘤的诊断和可切除性判断,手术切除仍是目前主要的治疗手段。

Objective To study the methods of pre-operative diagnosis and surgical treatment of huge cystic and solid tumor of pancreas. Methods Result of the diagnosis and treatment of patients with cystic and solid tumor of pancreas （tumor size larger than 8cm in diameter） in Huashan Hospital were analyzed retrospectively. Results From 1999 to date, Huashan hospital has an accumulated total of 15 patients with cystic and solid tumor of pancreas of size larger than 8cm in diameter,of which 3 patients were male, 12 were female and age of the patients ranged from 15 years to 73 years. The pre - operative diagnosis was based on several investigations such as uhrasonography, CT scan, DSA and serum tumor markers. All the 15 patients were treated by radical resection. The pathology diagnosis showed 9 solid-psuedopapillary tumor of pancreas（SPT） ,4 cystadenoma,2 cystadenocarcinoma. Condusion Radical surgical resection was most effective method for the treatment of huge cystic and solid tumor of pancreas. Spiral CT scan, DSA combined with detecting of tumor markers might be helpful for the differential diagnosis and judgment of tumor respectability.