胰腺囊性肿瘤的临床诊治

Diagnosis and Management of Cystic Tumors of the Pancreas

提高对胰腺囊性肿瘤诊断和治疗的认识,减少这种少见肿瘤的误诊误治。方法:对1958年4月～1995年7月经病理证实的15例胰腺囊性肿瘤病人进行回顾性分析。结果:15例胰腺囊性肿瘤中,浆液性囊腺瘤6例,粘液性囊性肿瘤9例。肿瘤位于胰头部4例,体尾部10例,全胰1例。15例病人全部进行手术治疗,其中12例获手术切除,切除率为80％。术前明确诊断为胰腺囊性肿瘤者仅6例,其余9例术前被误诊为胰腺假性囊肿或中、上腹肿块而行手术,其中7例术中被诊为囊性肿瘤而获相应的根治性切除,另2例被错误地进行了内引流术。结论:胰腺囊性肿瘤临床上常被误诊,只要综合运用病史分析、影像学特点、囊液分析、术中活检等方法,就能提高诊断的准确率。胰腺囊性肿瘤手术切除率高,预后较好。

Aims:To improve the understanding of cystic tumor of pancreas and to avoid errors in its diagnosis and management. Methods: We retrospectively studied 15 patients with pathologically confirmed cystic tumors of pancreas from Apr 1958 to Jul 1995. Results: Of all the 15 patients, 6 were serous cystadenomas, 9 were mucinous cystic tumors, 4 were located in the pancreatic head, 10 were bodytail or tails and 1 involved the whole pancreas. All of the 15 patients were taken operations, the resectable rate was 80%. Only 6 patients were clearly diagnosed as cystic tumor before operation, and other 9 patients were mistaken for pseudocysts or upper abdominal mass. Seven of 9 patients got correct diagnosis during operations and fortunately got curative resection; while the other 2 patients were taken improper internal drainage. Conclusions: Cystic tumors of pancreas are often misdiagnosed in clinic practice. Detailed history, imaging examination, cyst fluid analysis and biopsy histologic examination are main diagnostic workups. The resectable rate of pancreatic cystneoplasmas is inspiring and the prognosis is good.