胰腺浆液性囊腺瘤的诊断与治疗:附22例报告

Diagnosis and treatment of pancreatic serous cystoadenoma: a report of 22 cases

目的：总结胰腺浆液性囊腺瘤的诊断和治疗经验。方法：回顾性分析2004年1月-2010年12月收治的22例胰腺浆液性囊腺瘤患者的f艋床资料。结果：22例中男4例，女18例；年龄16—74（平均47．0）岁。患者多以腹痛腹胀等非特异性症状就诊，部分无症状。超声诊断灵敏度为86．3％（19／22），CT诊断灵敏度为93．8％（15／16），MRI诊断灵敏度为100％（12／12）。患者均接受手术治疗及病理检查证实，其中5例行胰十二指肠切除术，1例行保留十二指肠的胰头切除术，2例行胰腺中段切除术，3例行胰体尾切除术，5例行胰体尾及脾切除术，2例行腹腔镜下胰体尾及脾切除术，4例行胰腺肿瘤局部剜除术。全组无围手术期死亡，术后5例发生胰瘘，1例发生胰腺残端出血，1例发生胃排空延迟，均经保守治疗后好转出院。随访10个月至6年，均未发现肿瘤复发。结论：胰腺浆液性囊腺瘤多见于中老年女性，超声、cT及MRI诊断价值高，手术是安全有效的治疗方法。

Objective： To review the diagnosis and management of serous cystadenoma of the pancreas. Methods： The clinical records of 22 patients with pancreatic serous cystoadenoma admitted from 2004 January to 2010 December were retrospectively analyzed. Results： Of the 22 patients, 4 were male and 18 were female, and their ages ranged from 16 to 74 （average of 47.0） years. Majority of patients were admitted for non-specific abdominal distension or pain, and some of them had no symptoms at all. The diagnotic sensitivity of ultrasound, CT and MRI for this diseasewas 86.3% （19/22）, 93.8% （15/16） and 100% （12/12）, respectively. All patients underwent surgical treatment and the diagnoses were validated by pathological examination. Of the patients, 5 cases underwent pancreatoduodenectomy, 1 case underwent duodenum-preserving pancreatic head resection, 2 cases underwent middle segment pancreatectom）5 3 cases underwent distal pancreatectomy, 5 cases underwent distal pancreatectomy and splenectomy, 2 cases underwent laparoscopic distal pancreatectomy and splenectomy, and 4 cases underwent pancreatic tumor enucleation. In the entire group, there was no perioperative death, whereas postoperative pancreatic fistula occurred in 5 cases, and bleeding of the pancreatic stump and delayed gastric emptying occurred in 1 case each. All these complications were resolved before the patients were discharged. All the patients were followed up for 10 months to 6 years and there was no recurrence. Conclusion： Pancreatic serous cystoadenoma is mainly seen in middle-aged and elderly women, and for this condition, ultrasound, CT and MRJ examinations have high diagnostic value, and surgical resection is safe and effective treatment.