原发性十二指肠肿瘤的诊断与治疗

The Diagnosis and Treatment of Primary Tumor of Duodenum

目的:探讨原发性十二指肠肿瘤的临床表现、诊断与治疗方法。方法:回顾分析10例十二指肠肿瘤的临床资料。结果:10例原发性十二指肠肿瘤均经手术及病理证实;平滑肌瘤2例,行局部切除;乳头部腺瘤伴局部恶变1例行局部切除,姑息性切除2例。行胰十二指肠切除5例。首发表现为腹部疼痛(90％)、黄疸(40％)及消化道出血(10％)。结论:原发性十二指肠肿瘤缺乏特异性症状,经内镜、胃肠钡餐和CT等联合检查,阳性率可提高。对良性肿瘤可行十二指肠节段切除或局部切除,对恶性肿瘤首选胰十二指肠切除术。

Objective: To evaluate the clinical manifestations, diagnostic procedures and treatment of primary tumor of duode-num (PTD).Methods: The clinical data of 10 cases with PTD were analyzed retrospectively. Results: 10 cases of PTD were resected and confirmed by pathology. 2 cases of leiomyoma were resected simply , 1 cases of adenoma with partly malignant in the section of nipple was simply resected. 2 PMTD were appeasemently resected . 5 cases underwent pancreatoduodenectomy. The primary presenting symptoms and signs were abdominal pain(90%) ,jaudice(40%) ,GI obstruction (30%),GI hemor-rhage (10%).Conclusion; Patients with PTD usually lack specific symptoms and signs, combined with endoscope ,GI barium meal and CT can improve the positive rate.Segmental duodenectomy and simple tumor resection are curable for PBTD, while for PMTD the therapy of choice should be pancreatoduodenectomy.