胰腺实性假乳头状瘤58例手术治疗及预后分析

Surgical management and outcome of solid-pseudopapillary tumor of pancreas： a series of 58 cases

目的探讨胰腺实性假乳头状瘤手术治疗及预后特点。方法回顾分析2001年1月至2010年12月58例胰腺实性假乳头状瘤病例的临床资料。其中男性7例，女性51例；年龄9—70岁，平均30岁。多数患者有腹痛症状。手术治疗包括胰十二指肠切除术21例，远端胰切除术30例，中段胰切除术6例，肿瘤局部剜除术1例，保留十二指肠胰头切除术1例。结果住院时间12～64d，平均23．8d。术后出现并发症13例（22．4％），其中8例A级胰漏，1例消化道出血，2例胸腔积液，2例切口液化、感染。分别因消化道出血及切口严重感染再次手术2例；无住院期间死亡。44例获得随访，随访7～136个月，平均41个月；其中8例发生术后消化不良，4例发生糖尿病，无术后复发、转移及死亡。结论胰腺假乳头状瘤为潜在低度恶性肿瘤，好发于年轻女性，手术治疗效果较好。

Objective To study the surgical management pancreas （SPTP） and its characteristics of outcome. Methods of solid-pseudopapillary tumor of the Fifty-eight patients with SPTP of the pancreas admitted from January 2001 to December 2010 were retrospectively analyzed. There were 7 male and 51 female patients, with an average age of 30 years （ rangeing 9 to 70 years）. Most patients were symptomatic before admission; the most common symptom was abdominal pain. Of the 58 patients, 21 patients underwent pancreaticoduodenectomy, 30 patients underwent distal pancreatectomy, 6 patients underwent central pancreatectomy, 1 patient underwent simple tumor enucleation, and 1 patients underwent duodenum-preserving pancreatic head resection. Results The average length of stay in hospital was 23.8 days （ranging 12 to 64 days）. Thirteen patients （22.4%） developed postoperative complications, including grade A postoperative pancreatic fistula of 8 cases, gastrointestinal tract bleeding of 1 case, pleura1 effusion of 2 cases, wound infection and fat liquefaction of 2 cases. Two patients underwent reoperation due to gastrointestinal tract bleeding or wound infection. There was no hospital death. Forty-four patients were followed-up for 7 to 136 months with an average of 41 months. All the 44 patients were alive, while 8 patients developed dyspepsia and 4 patients developed diabetes mellitus. There were no tumor recurrences or metastasis. Conclusions SPTP is found primarily in young women. Excellent prognosis would be achieved with surgical resection.