胰腺黏液性囊性肿瘤临床诊断及治疗

Diagnosis and treatment of mutinous cystadenoma of the pancreas

目的 探讨胰腺黏液性囊性肿瘤的诊断和治疗方法.方法 回顾性分析2000年5月至2009年5月经手术并病理证实为胰腺黏液性囊性肿瘤12例患者的临床特点和治疗结果.结果 术前查超声、CT和MRCP,确诊率分别为50.0%（5/10）、66.7%（6/9）和83.3%（5/6）.完整手术切除率为91.7%（11/12）,姑息切除1例.术后胰漏3例,2例治愈;1例术后1个月死亡,死亡原因为胰漏合并腹腔感染.1例术后25个月死于肿瘤复发转移.结论 胰腺黏液性囊性肿瘤缺乏特异性临床表现,联合应用影像手段可以提高确诊率;对于胰腺黏液性囊性肿瘤应积极手术,根据肿瘤的部位采取不同的手术方式.

Objective To investigate the diagnosis and treatment of mutinous cystadenoma of the pancreas.Method The clinical data of 12 cases with pancreatic mutinous cystadenoma was confirmed by pathology from May 2000 to May 2009 was retrospectively analysed.Results The accuracy rates of ultrasound,CT and MRCP were 50.0%（5/10）,66.7%（6/9）and 83.3%（5/6）respectively.Pancreaticoduodenectomy,duodenum-preserving pancreatic head resection,distal pancreatic resection,distal pancreaticresection and splenectomy,segment pancreatic resection were performed according to the site of tumors.Completed resectable rate was 91.7%（11/12）,palliative resection in 1 case,postoperative pancreatic leakage in 3 cases.2 cases cured;1 case died of intra-abdominal infection caused by pancake fistula 1 month later;1 case died of tumor recurrence and metastasis 25 months later.Conclusions Pancreatic cystic neoplasms is lack of specific clinical manifestations.Combined with application of imaging methods,can improve the diagnosis rate.Operation is the most effective therapy.The feasible procedures for mucinous cystadenoma of the pancmas should be choiced according to the site of tumors.