十二指肠良性肿瘤15例诊治体会

Experience in diagnosis and treatment of benign tumor of duodenum: report of 15 cases

目的 探讨十二指肠良性肿瘤的诊断和治疗方法。方法 回顾分析本院收治的 15例十二指肠良性肿瘤并进行随访研究。结果 Brunner瘤 3例 ,平滑肌瘤 3例 ,间质瘤 3例 ,管状腺瘤 2例 ,管状绒毛状腺瘤 1例 ,胃泌素瘤 1例 ,血管瘤 1例 ,错构瘤 1例。十二指肠良性肿瘤临床症状不典型 ,术前确诊困难。胃十二指肠镜检查和上消化道造影确诊率不高。本组 14例手术切除肿瘤 ,总体1年、3年、5年生存率分别为 91.7%、81.8%、77.8%。结论 反复腹痛和黑便是十二指肠良性肿瘤最常见的症状 ;胃十二指肠镜检查和上消化道造影是主要的诊断方法 ;手术切除是首选治疗方法 ,预后良好。

Objective To further document the experience of diagnosis and treatment for the patients with benign duodenum tumor. Methods The data of 15 patients with benign tumor of duodenum diagnosed pathologically in our department from 1996 to 2002 were analyzed retrospectively. Of the 15 patients, 3 were Brunner's gland adenoma, 3 leiomyoma, 3 mesenchymoma, 2 tubular adenoma, 1 tubulovillous adenoma, 1 gastrinoma, 1 hemangioma and 1 hamartoma. Since the clinical symptoms of the patients with benign tumors of duodenum were always obscure and non specific, the diagnosis was difficult pre operation. Abdominal pain and melena were the main symptoms. Gastroduodenoscopy and upper gastrointestinal tract barium X ray examination were performed before operation in 12 and 9 patients respectively. Six patients underwent tumor resection, 3 tumor resection and sphincteroplasty, 3 pancreaticoduodenoctomy, 2 Billrith Ⅰ or Billrith Ⅱgastrectomy, 1 without operation. The 1 , 3 and 5 year survival rate was 91.7 % , 81.8 % , and 77.8 % , respectively. Conclusion Abdominal pain and melena are the main symptoms of the patients with benign tumor of duodenum. Gastroduodenoscopy and upper gastrointestinal tract X ray examination are major methods for diagnosis. The best treatment is to resect the tumor. The prognosis is satisfactory.