保留幽门的胰十二指肠切除术治疗胰头实性假乳头状瘤临床分析

Pylorus-preserving pancreaticoduodenostomy for solid-pseudopapillary tumor in pancreatic head

目的：总结保留幽门的胰十二指肠切除术治疗的胰头实性假乳头状瘤病例的诊疗经验。方法回顾性分析2005年11月至2014年10月期间北京协和医院收治的7例行保留幽门的胰十二指肠切除术治疗的胰头实性假乳头状瘤病人的临床资料。结果病人年龄分布为16～44岁,平均年龄28.1岁,男∶女=1∶6,术后有4例病人发生胃排空障碍（57.1%）,携带引流管时间为21～68 d,平均时间为38 d,有2例病人术后发生胰瘘合并腹腔感染（33.3%）。全部病人均接受密切随访,随访时间为15～108个月,平均60.4个月,均无明显肿瘤复发及远处器官转移发生。结论胰腺实性假乳头状瘤是低度恶性肿瘤,应用保留幽门的胰十二指肠切除术治疗胰头实性假乳头状瘤,病人术后胃排空障碍发生比例明显增高,但远期治疗效果很好,值得推广。

Objective To summarize the treatment experiences of solid-pseudopapillary tumor （SPT）in pancreatic head by pylorus-preserving pancreaticoduodenostomy （PPPD）.Methods Retro-spective analyses were performed for 7 cases of SPT in pancreatic head undergoing PPPD between No-vember 2005 and October 2014.Results There were 6 females and 1 male with an average age of 28.1 （16-44）years.Four cases （57.1 %）had functional delayed gastric emptying after operation.The average drainage time was 38 （21-68）days.Two cases （33.3%）had pancreatic fistula and peritoneal cavity infection after operation.During an average follow-up period of 60.4 （1 5-108）months,neither relapse nor metastasis occurred.Conclusions With a low potential malignancy,SPT has a high incidence of functional delayed gastric emptying after PPD in pancreatic head.And its satisfactory long-term outcomes justify a wider popularization.