无黄疸期壶腹周围癌的诊治体会

The experience of diagnosis and treatment in the periampullary carcinoma without jaundice

目的探讨无黄疸期壶腹周围癌的临床特征及诊治体会。方法回顾性分析27例无黄疸表现的壶腹周围癌的临床资料。结果 27例患者中23例有长期上腹部隐痛不适,7例合并上腹部饱胀,5例为胆道术后T管不能拔除,2例合并胆管炎。肿瘤指标未超过正常值三倍。MRCP提示胆胰管扩张的有21例,ERCP提示肿瘤有22例。结论壶腹周围癌早期无特异性症状,胆胰管扩张是其一个影像学特征,ERCP可提高早期诊断率,胰十二指肠切除术是其首选术式。

Objective To explore the clinical features,diagnosis and treatment of the periampullary carcinoma without jaundice.Methods The clinical data of 27 cases of periampullary carcinoma without jaundice were analyzed retrospectively.Results In 27 patients,chronic upper abdominal pain in 23 patients was relieved,7 cases had upper abdominal fullness,5 cases with biliary T tube could not be removed after biliary tract surgery,2 cases had cholangitis,the levels of tumor markers in all patients were not more than three times of the normal.MRCP showed expansion of bile duct in 21 cases,22 cases were diagnosed by ERCP.Conclusion Periampullary cancer has not specific symptoms in early stage,bile duct expansion is one of its imaging features,ERCP can improve the early diagnosis,pancreaticoduodenectomy is the preferred surgery.