胰腺实性假乳头状瘤的诊断和外科治疗

Diagnosis and surgical treatment of solid pseudopapillary tumor of pancreas

目的研究胰腺实性假乳头状瘤的临床病理特点,总结诊断和治疗经验。方法回顾性分析中南大学湘雅医院普外科2002年1月至2010年11月间收治的16例经手术和病理证实的胰腺实性假乳头状瘤病例,研究其临床和病理资料,总结诊断和治疗经验。结果 16例病人中男2例,女14例,中位年龄30.2岁。其中6例呈实性,9例呈囊实性,1例呈囊性。16例中14例获得完整切除(R0)。手术方式包括胰体尾切除术9例(其中保脾手术5例),胰中段切除术3例,胰十二指肠切除术1例,胰体尾切除并胰头肿块局部切除术1例。2例未获切除。本组术后无一例住院期死亡,总的并发症率31.2%。随访显示获得完整切除的14例病人均无瘤存活。而2例未获切除者分别于术后1年和2年死亡。结论胰腺实性假乳头状瘤大多具有良性的生物学行为和良好预后。避免误诊和积极的手术态度是进一步提高疗效的关键。

Objective To investigate the clinical and pathological features of solid pseudopapillary tumor(SPT).Methods 16 cases of SPT were included in this retrospective study.The clinical and pathological data were reviewed.Results Fourteen(87.5%) were female and median age at diagnosis was 30.2 years.There were 6 cases of solid type,9cases of cystic-solid type and 1 case of cystic type.Fourteen patients underwent complete resection of their SPT,including nine patients with distal pancreatectomy(including 5 spleen-preserving operations),3 patients with middle pancreatectomy,1 patient with pancreaticoduodenectomy and 1 patient with distal pancreatectomy and enucleation of mass in pancreatic head.All fourteen patients with complete resection of SPT are still alive without recurrence and 2patients without resection died of SPT.Conclusion Most of SPT has benign biological behavior and good prognosis.The key to improve prognosis is correct diagnosis and complete resection.