胰腺囊性肿瘤39例临床分析.docVIP

胰腺囊性肿瘤39例临床分析 　　[摘要] 目的 探讨胰腺囊性肿瘤临床特点及治疗方法。 方法 回顾性分析2004年1～12月深圳市人民医院收治的39例胰腺囊性肿瘤病例的临床资料，包括诊断、治疗方案、病理结果以及随访情况。 结果 39例胰腺囊性肿瘤中，导管内乳头状黏液性肿瘤（IPMN）10例（25.6%），黏液性囊腺瘤（MCN）7例（17.9%），浆液性囊腺瘤（SCN）12例（30.8%），实性假乳头状瘤6例（15.4%），无功能性神经内分泌肿瘤4例（10.3%）。患者无特征性的临床表现；CT和MRI对胰腺囊性肿瘤的鉴别诊断具有重要的意义。39例中手术治疗30例，B超引导下穿刺活检1例，内镜下胰管支架内引流2例，保守治疗6例。胰腺囊性肿瘤术后并发症总发生率为33.3%，无手术死亡病例。所有患者随访3～60个月，1例发生术后远处转移；保守治疗及内引流术患者均有不同程度肿瘤进展或症状反复。 结论 CT及MRI是胰腺囊性肿瘤术前诊断的主要手段；胰腺囊性肿瘤总体预后好，主张积极手术，功能保留性手术及腹腔镜手术值得临床推广。 　　[关键词] 胰腺囊性肿瘤；诊断；治疗 　　[中图分类号] R735.9 [文献标识码] A [文章编号] 1673-7210（2015）07（b）-0101-04 　　[Abstract] Objective To investigate the clinical features and treatment of pancreatic cystic neoplasms （PCNs）. Methods The clinical data including diagnosis， treatment， pathology and follow-up of 39 cases of pancreatic cystic neoplasm from January 2004 to December 2014 in Shenzhen Peoples Hospital were retrospectively analyzed. Results 10 patients were diagnosed with intraductal papillary mucinous neoplasm， 7 cases with mucinous cystic neoplasm， 12 cases with serous cystadenomas， 6 cases with solid pseudopapilary neoplasm， and 4 cases with nonfunctional neuroendocrine neoplasm. Patients with pancreatic cystic neoplasm had no specific clinical feature. Computed tomography （CT） and magnetic resonance imaging （MRI） were of great importance for the differential diagnosis of PCNs. 30 patients underwent operation， 1 patient underwent ultrasound guided puncture biopsy. 2 patients underwent endoscopic stent drainage of the pancreatic duct and 6 patients underwent expectant treatment. The incidence rate of postoperative complications was 33.3%， no patients died during peroperative period. All patients were followed-up for 3 to 60 months. Postoperative metastasis was found in 1 patient. Patients with expectant treatment and internal drainage underwent tumor progression or developed symptom relapse during surveillance. Conclusion CT and MRI are the main methods to diagnose PCNs. Operation is advocated according to good prognosis o