胰腺导管内乳头状黏液性肿瘤的外科诊治进展

Diagnosis and therapy of intraductal papillary mucinous tumor of the pancreas

目的探讨胰腺导管内乳头状黏液性肿瘤的外科诊治进展。方法回顾分析1993年6月～2011年3月笔者所在医院收治的13例胰腺导管内乳头状黏液性肿瘤患者资料。结果 13例胰腺导管内乳头状黏液性肿瘤患者中其中男9例,女4例,年龄44～76岁,中位年龄为61.4岁。临床表现为反复发作性上腹痛6例(46.1%),腹胀5例(38.5%),位于胰头部10例,胰体2例,胰尾1例。肿瘤平均最大径6.2cm,术前CT及MRI的定位准确率较高。11例患者接受手术治疗,胰头十二指肠切除术9例,胰体尾切除术2例,2例拒绝手术仅做内镜下胰管支架植入术。13例患者平均随访时间为(51±4.2)个月(4～115个月),其中无一例手术死亡、转移。结论手术切除是治疗胰腺导管内乳头状黏液性肿瘤的首选治疗方法,影像学、实验室检查对本病的诊断及鉴别诊断有重要作用。

Objective To explore the progress of the diagnosis of intraductal papillary mucinous tumor （IPMT） of the pancreas. Method From June 1993 to March 2011, in our hospital were retrospectively analyzed 13 cases of pancreatic intraductal papillary mncinous tumors information. Results 13 cases of intraductal papillary mucinous pancreatic cancer patients including 9 males and 4 females, aged 44 to 76 years, with a median age of 61.4 years. Clinical manifestations of recurrent abdominal pain in 6 cases （46.1%）, abdominal distension in 5 eases （38.5%） , 10 cases in the pancreatic head, 2 cases in the pancreatic body, 1 case of pancreatic tail. The average maximum tumor diameter 6.2 cm, preoperative CT and MRI high positioning accuracy. 11 patients underwent surgery, Pancreatieoduodenectomy in 9 cases of pancreatic resection in 2 cases, 2 cases refused to do endoscopic surgery only pancreatic stenting. All the patients were followed up, and the mean postoperative followup period was （51 ＋4.2）months （range 4 to 115 months）. There was no death and no metastasis of all postoperative patients. Conclusions Surgical resection should be performed in patients with IPMT of the pancreas. Imaging and laboratory examination are helpful in the diagnosis.