微创外科时代胰腺囊性肿瘤的诊断和治疗

Diagnosis and treatment of pancreatic cystic neoplasms in the era of minimally invasive surgery

胰腺囊性肿瘤占胰腺囊性疾病的10%~15%,随着影像诊断技术的普及和医疗水平的发展,其检出率不断增加。它多为良性或低度恶性肿瘤,存在恶变可能,需要手术切除,且适合微创手术。当然,胰腺手术并发症率高,仍然是高风险手术,其早期精确的诊断对决定合理的治疗至关重要。对于大多数胰腺囊性肿瘤,胰腺增强CT,必要时结合MRCP或MRI,足以做出诊断。超声内镜检查+穿刺抽液有助于确定诊断和手术时机。手术方式的选择取主要取决于囊性肿瘤的性质及位置。

Pancreatic cystic neoplasms account for 10%to 15%of all pancreatic cystic lesions,and their detection rates are increasingly rising with use of advanced imaging techniques and development of medical technologies.They are mostly benign or low-grade malignant tumors with the possibility of malignant transformation,and require surgical resection,and are also suitable for minimally invasive surgery.However,pancreatic surgery is still a highrisk procedure due to high complication rates,and precise early diagnosis is crucial for ensuring correct treatment.For most pancreatic cystic neoplasms,enhanced pancreatic CT or if necessary,in combination with MRCP or MRI is sufficient to achieve a correct diagnosis.Endoscopic ultrasonography plus puncture aspiration is helpful for diagnosis confirmation and determining the timing of surgery.The choice of surgical procedures mainly depends on the location and nature of the tumors.