• 首都醫(yī)科大學(xué)宣武醫(yī)院普外科(北京 100053);

目的  探討胰腺囊性腫瘤的診治方法。
方法  回顧性分析29例胰腺囊性腫瘤患者的臨床資料,包括一般資料、臨床表現(xiàn)、輔助檢查、手術(shù)方法、病理結(jié)果、術(shù)后并發(fā)癥和隨訪結(jié)果。
結(jié)果  8例(28%)漿液性囊性腫瘤(SCN),12例(41%)黏液性囊性腫瘤(MCN),3例(10%)導(dǎo)管內(nèi)乳頭狀黏液腫瘤(IPMN),6例(21%)實(shí)性假乳頭狀腫瘤(SPT)。8例SCN、7例MCN、1例IPMN和5例SPT均是良性腫瘤。76%(22/29)患者是女性,年齡(49±17)歲(15~78歲)。29例中行手術(shù)治療23例,其中切除腫瘤22例,探查活檢1例,圍手術(shù)期無(wú)死亡病例;另外6例未手術(shù)者中4例SCN者行隨訪觀察處理,2例IPMN者拒絕手術(shù)治療。29例患者中獲隨訪21例,隨訪時(shí)間為(2.7±2.3)年(6個(gè)月~8年),失訪8例。16例腫瘤切除者隨訪期內(nèi)腫瘤無(wú)復(fù)發(fā),1例探查活檢者術(shù)后1年死亡;4例未手術(shù)的SCN患者隨訪期內(nèi)腫瘤無(wú)明顯增大。
結(jié)論  胰腺囊性腫瘤中最常見(jiàn)的是黏液性腫瘤和漿液性腫瘤,多見(jiàn)于女性; 漿液性腫瘤均為良性,42%的黏液性腫瘤是惡性;誤診將延誤治療,增加死亡率。胰腺囊性腫瘤手術(shù)切除率高,根治性切除后預(yù)后好。

引用本文: 王亞軍,李非,孫家邦,李昂,曹鋒,方育,李嘉,賈建國(guó),陳宏,楊鵬. 胰腺囊性腫瘤臨床診治分析. 中國(guó)普外基礎(chǔ)與臨床雜志, 2012, 19(4): 424-428. doi: 復(fù)制

1. Fitzgerald TL, Hickner ZJ, Schmitz M, et al. Changing incidence of pancreatic neoplasms:a 16-year review of statewide tumor registry [J]. Pancreas, 2008, 37(2):134-138.
2. Kloppel G, Kosmahl M. Cystic lesions and neoplasms of the pancreas. The features are becoming clearer [J]. Pancreatology,2001, 1(6):648-655.
3. Adsay NV. Cystic neoplasia of the pancreas: pathology and biology [J]. J Gastrointest Surg, 2008, 12(3):401-404.
4. Federle MP, McGrath KM. Cystic neoplasms of the pancreas [J]. Gastroenterol Clin North Am, 2007, 36(2):365-376.
5. 王亞軍, 孫家邦. 胰腺囊性腫瘤的診治體會(huì) [J]. 臨床肝膽病雜志, 2010, 26(5):472-475.
6. Allen PJ, Brennam MF. The management of cystic lesions of the pancreas [J]. Adv Surg, 2007, 41(2): 211-228.
7. Paye F, Sauvanet A, Terris B. Intraductal papillary mucinous tumors of the pancreas:pancreatic resections guided by preoperative morphological assessment and intraoperative frozen section examination [J]. Surgery, 2000, 127(5):536-544.
8. Galanis C, Zamani A, Cameron JL, et al. Resected serous cystic neoplasms of the pancreas:a review of 158 patients with recommendations for treatment [J]. J Gastrointest Surg, 2007, 11(7):820-826.
9. Yamaguchi K, Kanemitsu S, Hatori T, et al. Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN [J]. Pancreas, 2011, 40(4):571-580.
10. Llatas J, Palomino A, Frisancho O. Frantz tumor:a pancreaticpseudopapillary solid neoplasia [J]. Rev Gastroenterol Peru,2011, 31(1):56-60.
11. Friebe V, Keck T, Mattern D, et al. Serous cystadenocarcinoma of the pancreas: management of a rare entity [J]. Pancreas,2005, 31(2):182-187.
12. Tseng JF, Warshaw AL, Sahani DV. Serous cystadenoma of the pancreas:tumor growth rates and recommendations for treatment[J]. Ann Surg, 2005, 242(3):413-419.
13. Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas [J]. N Engl J Med, 2004, 351(12):1218-1226.
14. Bassi C, Salvia R, Molinari E, et al. Management of 100 consecutive cases of pancreatic serous cystadenoma:wait for symptoms and see at imaging or vice-versa?[J]. World J Surg, 2003,27(3):319-323.
15. Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Cystic neoplasms of the pancreas [J]. J Gastrointest Surg, 2007, 11(9):1225-1227.
16. 孫備, 陳華. 胰腺癌外科治療的現(xiàn)狀與展望 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(8):547-549.
17. 陳天宇, 孫家邦. 胰腺實(shí)性假乳頭狀瘤8 例臨床報(bào)道 [J]. 首都醫(yī)科大學(xué)學(xué)報(bào), 2006, 27(3):391-394.
18. 張益軍, 翁永強(qiáng), 袁祖榮. 胰腺實(shí)性假乳頭狀瘤臨床治療體會(huì) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(6):611-612.
19. 陳磊, 曹葦, 趙鑫, 等. 胰腺實(shí)性假乳頭狀瘤診治分析( 附8例報(bào)道) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(7):764-766.
20. Sugiyama M, Suziki Y, Abe N, et al. Management of intraductal papillary mucinous neoplasm of the pancreas [J]. J Gastroenterol,2008, 43(3):181-185.
  1. 1. Fitzgerald TL, Hickner ZJ, Schmitz M, et al. Changing incidence of pancreatic neoplasms:a 16-year review of statewide tumor registry [J]. Pancreas, 2008, 37(2):134-138.
  2. 2. Kloppel G, Kosmahl M. Cystic lesions and neoplasms of the pancreas. The features are becoming clearer [J]. Pancreatology,2001, 1(6):648-655.
  3. 3. Adsay NV. Cystic neoplasia of the pancreas: pathology and biology [J]. J Gastrointest Surg, 2008, 12(3):401-404.
  4. 4. Federle MP, McGrath KM. Cystic neoplasms of the pancreas [J]. Gastroenterol Clin North Am, 2007, 36(2):365-376.
  5. 5. 王亞軍, 孫家邦. 胰腺囊性腫瘤的診治體會(huì) [J]. 臨床肝膽病雜志, 2010, 26(5):472-475.
  6. 6. Allen PJ, Brennam MF. The management of cystic lesions of the pancreas [J]. Adv Surg, 2007, 41(2): 211-228.
  7. 7. Paye F, Sauvanet A, Terris B. Intraductal papillary mucinous tumors of the pancreas:pancreatic resections guided by preoperative morphological assessment and intraoperative frozen section examination [J]. Surgery, 2000, 127(5):536-544.
  8. 8. Galanis C, Zamani A, Cameron JL, et al. Resected serous cystic neoplasms of the pancreas:a review of 158 patients with recommendations for treatment [J]. J Gastrointest Surg, 2007, 11(7):820-826.
  9. 9. Yamaguchi K, Kanemitsu S, Hatori T, et al. Pancreatic ductal adenocarcinoma derived from IPMN and pancreatic ductal adenocarcinoma concomitant with IPMN [J]. Pancreas, 2011, 40(4):571-580.
  10. 10. Llatas J, Palomino A, Frisancho O. Frantz tumor:a pancreaticpseudopapillary solid neoplasia [J]. Rev Gastroenterol Peru,2011, 31(1):56-60.
  11. 11. Friebe V, Keck T, Mattern D, et al. Serous cystadenocarcinoma of the pancreas: management of a rare entity [J]. Pancreas,2005, 31(2):182-187.
  12. 12. Tseng JF, Warshaw AL, Sahani DV. Serous cystadenoma of the pancreas:tumor growth rates and recommendations for treatment[J]. Ann Surg, 2005, 242(3):413-419.
  13. 13. Brugge WR, Lauwers GY, Sahani D, et al. Cystic neoplasms of the pancreas [J]. N Engl J Med, 2004, 351(12):1218-1226.
  14. 14. Bassi C, Salvia R, Molinari E, et al. Management of 100 consecutive cases of pancreatic serous cystadenoma:wait for symptoms and see at imaging or vice-versa?[J]. World J Surg, 2003,27(3):319-323.
  15. 15. Society for Surgery of the Alimentary Tract. SSAT patient care guidelines. Cystic neoplasms of the pancreas [J]. J Gastrointest Surg, 2007, 11(9):1225-1227.
  16. 16. 孫備, 陳華. 胰腺癌外科治療的現(xiàn)狀與展望 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(8):547-549.
  17. 17. 陳天宇, 孫家邦. 胰腺實(shí)性假乳頭狀瘤8 例臨床報(bào)道 [J]. 首都醫(yī)科大學(xué)學(xué)報(bào), 2006, 27(3):391-394.
  18. 18. 張益軍, 翁永強(qiáng), 袁祖榮. 胰腺實(shí)性假乳頭狀瘤臨床治療體會(huì) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(6):611-612.
  19. 19. 陳磊, 曹葦, 趙鑫, 等. 胰腺實(shí)性假乳頭狀瘤診治分析( 附8例報(bào)道) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(7):764-766.
  20. 20. Sugiyama M, Suziki Y, Abe N, et al. Management of intraductal papillary mucinous neoplasm of the pancreas [J]. J Gastroenterol,2008, 43(3):181-185.