胰腺浆液性囊腺瘤的诊断和治疗

Diagnosis and treatment of pancreatic serous cystadenoma

目的探讨胰腺浆液性囊腺瘤的诊断和治疗。方法对1995年6月至2005年6月复旦大学附属中山医院收治的16例胰腺浆液性囊腺瘤病人的临床资料进行回顾性分析。结果胰腺浆液性囊腺瘤好发于女性,无特征性临床表现。B 超和 CT 诊断正确率分别为44%(7/16)和50%(8/16)。本组16例均行手术治疗,其中,胰十二指肠切除术8例,远端胰腺切除术3例,胰腺节段切除术2例,肿瘤摘除术3例,胰瘘是主要的并发症。本组13例获随访,3例失访。3例因其它疾病死亡,其余均健在,术后无复发。结论 B 超和 CT 是胰腺浆液性囊腺瘤主要的影像学检查方法,但准确率不高。有症状的胰腺浆液性囊腺瘤,或与黏液性囊性肿瘤不能鉴别的,应手术治疗。手术可行非根治性的胰腺切除术,甚至肿瘤摘除术。浆液性囊腺瘤手术切除后即可治愈。

Objective To investigate the diagnosis and treatment of pancreatic serous cystadenoma （PSC）. Methods The clinical data of 16 patients with PSC treated in our hospital from June 1995 to June 2005 were retrospectively analyzed. Results PSC predominantly occurred in women and its symptoms were often nonspecific. Ultrasonography and CT correctly diagnosed 44% and 50% of all the patients, respectively. All the 16 patients were surgically treated. Pancreaticoduodenectomy was performed in 8 patients, distal pancreatectomy in 3, segmental pancreatectomy in 2 and enucleation in 3. Postoperative pancreatic fistula was the leading complication. Thirteen patients were followed up. Of the 13 patients, 3 died for other causes and 10 survived without postoperative recurrence of PSC. Conclusions Ultrasonograpy and CT are the major imaging methods for diagnosis of PSC. Surgical resection is indicated when the tumor is symptomatic or could not be differentiated from a mucinous neoplasm. The conservative, non-radical resection or enucleation can be used when operation is necessary. PCS can be cured by complete resection.