十二指肠球部Brunner腺瘤内镜切除治疗的疗效分析

Clinical efficacy of endoscopic resection of duodenal Brunner's gland adenoma

目的探讨十二指肠球部Brunner腺瘤内镜切除的临床应用效果。方法回顾性分析2009年3月-2011年12月经内镜下切除治疗的18例十二指肠球部Brunner腺瘤患者的病例资料。术前均经超声内镜检查评估,术后均经病理证实,并进行随访观察。结果 18例Brunner腺瘤包括结节型16例,蚓型1例,盘型1例,均经内镜下切除,治疗成功率100%,术中创面渗血2例,均经内镜下热凝止血成功,无穿孔及死亡病例。术后病理均提示Brunner腺瘤,超声内镜诊断实质型12例,囊实混合型3例,多囊分隔型3例。随访时间12~45（25.6±10.1）个月,无复发病例。结论超声内镜检查是有效的Brunner腺瘤术前诊断方法,Brunner腺瘤的内镜切除治疗安全有效。

Objective To discuss the clinical efficacy of endoscopic resection of duodenal Brunner＇s gland adenoma. Methods Eighteen patients with duodenal Brunner＇s gland adenoma were removed by endoscopic resection between Mar. 2009 and Dec. 2011. All the patients underwent endoscopic ultrasonography for preoperative diagnosis, and it was confirmed by postoperative pathological examination. A retrospective analysis was performed. Results Endoscopic resection was successful in all patients. The tumors presented as tubercular in 16 cases, earthworm like in 1 case, and disciform in 1. Blood oozing from the wound surface occurred in 2 cases during operation, and it was stopped by thermocoagulation successfully. No postoperative complication or fatality occurred in any patient. These adenomas were confirmed to be parenchymatous in 12 cases, cystic and solid in 3, and cystic in 3 by endoscopic ultrasonography and postoperative pathology. Follow-up for 12-45 （25.6±10.1） months did not find recurrence. Conclusions Endoscopic ultrasound examination is an effective preoperative diagnostic method in the patients with duodenal Brunner＇s gland adenoma. Endoscopic resection is safe and effective treatment for this tumor.