内镜黏膜剥离术治疗上消化道异位胰腺36例临床观察

Clinical observation of endoscopic submucosal dissection for uppergastrointestinal ectopic pancreas(36 cases)

目的探讨内镜黏膜剥离术(ESD)在上消化道异位胰腺病理诊断和临床治疗的价值。方法检索2012年1月1日-2014年11月30日在南京大学鼓楼临床医学院住院病例,筛选因异位胰腺住院行ESD的病例,归纳总结出资料完整的病例共36例,全部病例均经术后病理证实为异位胰腺,回顾分析操作过程、标本病理、随访治疗效果及并发症情况。结果 ESD治疗胃异位胰腺34例,十二指肠异位胰腺2例,平均操作时间66 min,平均切下标本大小21.0 mm×16.0 mm,标本完整切除率100.00%。随访并发症中,发热2例、上消化道出血1例、穿孔1例。结论 ESD是目前较先进的微创治疗手段,可完整切除病变组织,获取准确病理学诊断,是异位胰腺安全有效的治疗方法。

Objective To evaluate the feasibility, efficacy, and safty of endoscopic submucosal dissection（ESD） in treatment of uppergastrointestinal ectopic pancreas. Methods 36 uppergastrointestinal ectopic pancreas were treated with ESD from January 1 2012 to November 30 2014. The definitive histological diagnosis of ectopic pancreas was made after the endoscopic treatment. We analyzed the operation method, dissected tissue, complication, retrospectively. Results 34 cases were located in stomach, the other 2 in duodenum. All cases underwent ESD, the mean operating time was 66 min. The mean dissected tissue diameter was 21 mm × 16 mm in the 36 cases. The curative resection rate was 100.00 %. Bleeding rate of ESD was 2.77 %（1/36）. Perferation rate of ESD was 2.77 %（1/36）. 2cases suffered from low grade fever. None need surgical intervention. Recurrence rate was 0.00 %. Conclusions ESD is a minimally invasive technique that allows resection of whole lesions and provides precise histological information,which is particularly suitable for uppergastrointestinal ectopic pancreas.