胰腺囊性肿瘤的诊断与治疗.doc

胰腺囊性肿瘤的诊断与治疗 　　作者：施红旗，宋其同，陈宗静，李劲节，俞富祥，何瀚 作者单位：温州医学院第一附属医院 肝胆外科，浙江 温州 325000 　　【摘要】 目的 探讨胰腺囊性肿瘤的诊断与治疗方法。方法 对我院1985年1月至2006年12月间收治的11例胰腺囊性肿瘤的临床资料进行回顾性分析。结果 本组11例中，仅6例术前确诊为胰腺囊性肿瘤，术前误诊为胰腺假性囊肿4例，误诊为胆总管囊肿1例，误诊率为45.4%。行胰头部囊性肿瘤切除术2例，胰体尾部切除和脾切除术3例，囊性肿瘤局部切除术2例，囊肿空肠Roux Y吻合术3例，囊肿活检，囊腔内置管引流术1例。内引流术后并发胰性腹水1例，全组无手术死亡。结论 提高对本病的警惕性，常规行胰腺B超和CT检查是早期发现本病的有效方法，避免误诊和积极手术切除，可获得较好疗效。 　　【关键词】 胰腺囊性肿瘤，胰腺假性囊肿，诊断，治疗 　　Diagnosis and treatment of the pancreatic cystic tumors SHI Hongqi， SONG Qitong， CHEN Zongjing， et al. Department of Hepatobiliary Surgery， the First Affiliated Hospital of Wenzhou Medical College， Wenzhou 325000 　　Abstract Objective To probe the methods of diagnosis and treatment of the pancreatic cystic tumors. Methods Eleven cases of pancreatic cystic neoplasm admitted into our hospital from January 1985 to December 2006 were analyzed retrospectively. Results Of all the 11 patients in this group， only 6 were definitely diagnosed as cystic tumors of the pancreas preoperatively， 4 were mistaken for pseudocysts of the pancreas and 1 for choledochal cyst. The misdiagnosis rate was 45.4%. Two patients with cystic tumors of the pancreatic head were undergone cyst excision， and the body and tail of the pancreas and the spleen were resected in 3 patients， and 2 cases were undergone cyst partial excision， and 3 cases were treated with RouxenY cystojejunostomy， and 1 with exo drainage and biopsy. One case of pancreatic ascites was complicated after internal drainage of the cyst. There was no death in this group perioperatively. Conclusion To be of vigilance for the pancreatic cystic tumors， ultrasonography and CT are the most effective method to find the early cystic tumor of the pancreas， less misdiagnosis occurrence and active radical surgical resection may get longer survival. 　　Key words pancreatic cystic neoplasms; pancreatic pseudocyst; diagnosis; treatment 胰腺囊性肿瘤(pancreatic cystic tumor，PCT)是少见的胰腺外分泌肿瘤，包括胰腺浆液性囊腺瘤、胰腺黏液性囊腺瘤和囊腺癌。我院外科自1985年1月至2006年12月间共收治PCT患者11例，