假瘤样胰腺炎的诊断及处理(附8例报告)

Diagnosis and Treatment of Chronic Pseudotumiral Pancreatitis (A Report of 8 Cases)

为探讨假瘤样胰腺炎的诊断和处理，对１９９０～１９９７年间手术治疗的８例假瘤样胰腺炎进行了回顾性分析。患者均表现为胰腺局部占位性病变，行剖腹探查术。２例胰头部肿块行胰十二指肠切除术（Ｗｈｉｐｐｌｅ手术），１例尾部肿块行胰尾加脾切除术，３例头体部肿块伴有胆总管扩张梗阻性黄疸者行胆总管空肠Ｒｏｕｘ－ｅｎ－Ｙ吻合术，２例胰头部肿块无黄疸者行胆总管切开、Ｔ管引流术，术后病理检查均为炎症性改变。随诊结果显示：患者黄疸消退、肿块缩小、临床症状好转。结果表明：慢性局灶性胰腺炎不能排除恶性病变者宜行肿块切除术。胰腺炎性肿块伴有胆总管扩张、梗阻性黄疸者可行内引流术。

To explore the diagnosis and treatment of chronic pseudotumiral pancreatitis, the authors analysed retrospectively 8 patients with chronic pseudotumiral pancreatitis in their departmen from 1990 to 1997. All patients presented focalized masses in the pancreas and were treated surgically. Whipple resection were performed in two patients who had masses within the head of the pancreas. Distal pancreatectomy was performed in 1 case with mass in the tail of the pancreas. Choledochojejunostomy were performed in 3 cases with obstructive jaundice. T tube drainage of common bile duct was performed in 2 cases. Follow up showed the results were satisfactory. The results suggest that: ① If it is difficult to exclude suspicion of cancer in the chronic focalized pancreatitis, the mass should be resected. ② If the mass within the pancreas is inflammatory lesion, the internal or external drainage of the common bile duct can be performed.