胃异位胰腺患者应用内镜黏膜下剥离术和内镜黏膜下隧道剥离术的诊治分析

Analysis on endoscopic submucosal dissection and submucosal tunneling endoscopic resection for gastric ectopic pancreas

目的 探讨内镜黏膜下剥离术（ESD）和内镜黏膜下隧道剥离术（STER）在胃异位胰腺诊治中的价值.方法 86例疑诊为胃异位胰腺患者住院接受ESD或STER,随访观察治疗效果和安全性.结果 术后病理确诊胃异位胰腺54例,位于胃窦43例,胃底体交界7例,胃体4例;其中45例行ESD,9例行STER,完整切除率88.9％ （48/54）,余6例剥离后有少许组织残留.术后迟发性出血1例（1.9％,1/54）,无术中及术后穿孔.术后随访1～ 32个月未见复发.结论 ESD能完整大块地切除病变组织,能提供标本获得准确的病理学诊断,是胃异位胰腺有效且安全的诊治手段,STER可能为胃异位胰腺的诊治提供一种新的方法.

Objective To investigate the value of endoscopic submucosal dissection （ESD） and submucosal tunneling endoscopic resection （STER） for the diagnosis and therapy of gastric ectopic pancreas.Methods A total of 86 patients who were suspicion diagnose with gastric ectopic pancreas received ESD or STER in hospital,and the therapeutic effect and safety were followed-up.Results Fifty-four gastric ectopic pancreas patients were definitely diagnosed by postoperative pathology.Of the 54 patients,43 cases were located at the gastric antrum,7 cases were located at gastric fundus and gastric corpus juncture,4 cases were located at gastric corpus.Forty-five cases received ESD,9 cases received STER,rate of completely resection was 88.9% （48/54）,6 cases had a little tissue residual after resection.One case （1.9%,1/54） happened postoperative delay-bleeding,intraoperative and postoperative perforation was not found.During 1-32 months followed up,recurrence was not found.Conclusion ESD could excise the whole lesion to offer an accurate pathology diagnose,meanwhile good for treatment,ESD is an effective and relatively safe method for gastric ectopic pancreas,STER may be a new approach for gastric ectopic pancreas.