老年胰腺囊性肿瘤的诊断与治疗策略

Diagnosis and treatment strategies of pancreatic cystic neoplasms in elderly patients

胰腺囊性肿瘤(PCN)以囊性病变为主要特征,发病率相对较低。随着影像学技术的发展及筛查的普及,PCN检出率逐年增高,在老年群体中尤为显著。PCN种类繁多、鉴别诊断困难、存在潜在恶变风险,制订合理的诊断与治疗策略是其治疗的关键。国内外虽已相继发布多项PCN临床指南,但在诊断与治疗策略上仍存在诸多争议。老年患者体质通常较弱,部分伴严重合并症,对手术耐受性差,诊断与治疗过程中需要临床医师特殊关注、仔细评估、权衡利弊后,方能制订最佳治疗方案。笔者结合现有指南与临床经验,对老年PCN患者的诊断、手术指征、全程管理策略进行综合阐述,以期为该类疾病的诊断与治疗提供参考。

Pancreatic cystic neoplasm(PCN)is characterized by cystic degeneration with a low incidence.With the development of imaging technology and the popularization of screening,the detection rate of this disease has been increasing in recent years,especially in the elderly population.Due to the multiple subtypes of PCN,difficult differential diagnosis,and the potential risk of malig-nant transformation,the formulation of reasonable diagnosis and treatment strategy is the key to treat PCN.Although many clinical guidelines have been released,the diagnosis and treatment strategies of PCN are still controversial.Elderly patients are generally weak,some with serious comorbidities,and have poor tolerance to surgery.In the process of diagnosis and treatment,clinicians need to pay special attention,carefully evaluate and weigh the advantages and disadvantages,so as to make the best plan for treatment.Based on the current guidelines and clinical experience,the authors summarize the diagnosis,surgical indications,and the whole-course management strategies of elderly patients with PCN,in order to provide suggestions for the diagnosis and treatment of this disease.