异位胰腺32例临床诊治分析

Diagnosis and treatment of 32 cases with heterotopic pancreas

目的总结探讨异位胰腺的临床特点及诊治方式。方法 回顾分析北京协和医院1992～2010年经病理证实的32例异位胰腺患者的临床特点及诊治情况。结果 32例异位胰腺分布于胃(15例)、十二指肠(4例)、空肠(9例)和回肠(4例),其中26例为近4年检出。除8例术前获确诊外,6例误诊为胃肠间质瘤,5例误诊为平滑肌瘤,1例误诊为胃溃疡恶变;其余12例为其他腹部手术中发现。1例行胃镜活检证实,31例行手术切除后经术后病理确诊;所有患者无明显并发症发生。结论 胃肠道黏膜下隆起病变应考虑异位胰腺可能,确诊后可选择内镜摘除或手术切除。

Objective To investigate the clinical features and treatment methods of ectopic pancreas.Methods Retrospective analysis of 32 pathologically confirmed patients with ectopic pancreas in Peking Union Medical College Hospital from 1992 to 2010.Results Thirty-two cases with heterotopic pancreas located in the stomach（15 cases）,duodenum（4 cases）,jejunum（9 cases） and ileum（4 cases）,and 26 cases were detected in recent 4 years.Eight cases were diagnosed before surgery,6 cases were misdiagnosed as gastrointestinal stromal tumors,5 cases were misdiagnosed as leiomyoma,1 case was misdiagnosed as malignant gastric ulcer;the remaining 12 cases were found accidentally in other abdominal surgery.One case was confirmed by routine endoscopic biopsy,the rest 31 cases accepted surgical resection and confirmed by postoperative pathologic findings;all patients had no complications.Conclusion Gastrointestinal submucosal protuberant lesions should be considered the possibility of ectopic pancreas,endoscopic procedure or surgical resection are available if confirmed diagnosis is made.