内镜下十二指肠乳头腺瘤的临床诊治和分析(附16例报告)

Endoscopic diagnosis and treatment of duodenal papilla adenoma(report of 16 cases)

目的:分析我院内镜下治疗的16例十二指肠乳头腺瘤的临床资料,结合文献复习,总结临床诊治体会。方法:回顾性分析2015年5月-2018年9月于我院消化内镜中心治疗的16例十二指肠乳头腺瘤,其中男性10例,女性6例;平均年龄58.87岁(38~76岁)。肿物最大径平均值为1.27 cm(0.3~2.6 cm)。结果:16例患者均内镜下完成十二指肠乳头肿物切除,其中6例患者行内镜下胆胰管支架置入术;2例患者单独行胆管支架置入术;1例患者单独行胰管支架置入术。术后定期随访患者12~50月,均无复发及转移。结论:十二指肠乳头腺瘤在临床上属于罕见病例,具有癌变倾向,临床表现不典型;术前可通过胃镜取材病理判断肿物性质。对于十二指肠乳头腺瘤要做到早发现,早诊断,早治疗。相对外科手术,内镜下十二指肠乳头腺瘤切除术创伤小、并发症少、恢复快、费用低,是有效的临床治疗手段。

Objective:To analyze clinical data of 16 cases of duodenal papilla adenoma treated with endoscopy in our hospital,and to summarize experience of clinical diagnosis and treatment combined with literature review.Methods:From May 2015 to September 2018,16 cases of duodenal papilla adenoma were treated in department of digestive endoscopy in our hospital,including 10 males and 6 females,with an average age of 58.87 years(38~76 years).The average size of maximum diameter of the tumor was 1.27 cm(0.3~2.6 cm).Results:Endoscopic resection was performed in all 16 patients,of which 6 patients underwent endoscopic stent placement of choledochopancreatic duct.Bile duct stenting was performed in 2 patients and pancreatic stenting was performed in 1 patient.No recurrence and metastasis was found during the follow-up for 12~50 months.Conclusion:Duodenal papilla adenoma is rare in clinic with atypical clinical manifestation,which has the tendency of canceration.Histology type of tumor can be judged by gastroscopy and pathology before operation.Early detection,early diagnosis and early treatment ofduodenal papilla adenoma are necessary.Compared with surgery,endoscopic resection of duodenal papilla adenoma is an effective treatment with advantages of less trauma,less complication,faster recovery and lower cost.