摘要
目的探讨胰腺颈部和体部良性肿瘤的诊断和治疗方法,尤其是手术方式对预后的影响。方法回顾性分析14年间收治的29例患者的临床资料。结果所有病例均行胰腺增强CT检查,28例发现胰腺占位病变。29例均行上腹部超声检查,25例发现胰腺病变。摘除术13例中8例发生胰瘘,胰体尾脾切除术8例中6例发生胰瘘,保留脾的胰体尾切除术2例均未发生胰瘘,中段胰腺切除术6例中有1例发生胰瘘。病理诊断:胰岛素瘤11例,无功能胰岛细胞瘤8例,黏液性囊腺瘤9例,浆液性囊腺瘤1例。17例应用生长抑素病人中有8例发生胰瘘,12例未应用生长抑素病人中有7例发生了胰瘘,两者之间相比较差异无显著性(P>0.05)。在胰瘘闭合时间上应用生长抑素组平均为8.5d,未应用组达20d,两组之间差异有显著性(P<0.05)。结论胰腺颈部和体部的良性肿瘤应该选择摘除术或中段胰腺切除术。生长抑素不能预防胰瘘的发生,但是可以缩短胰瘘闭合的时间。
[ Objective ] To discuss the diagnosis and treatment of the benign tumors of neck and body of pancreas, especially the relationship between surgical options and prognosis. [Methods] The clinical data of twentynine patients with benign lesions of the neck and body of pancreas were retrospectively analyzed in our hospital during the past fourteen years. [Results] 28 out of 29 cases undergoing preoperative CT scan had positive locations. For ultrasonography, the positive rate was 25 out of 29 cases. Pancreatic leak was verified in 8 out of 13 cases with pancreatic enucleation, 6 out of 10 cases with distal pancreatectomy with or without splenectomy and 1 out of 6 cases with central pancreatectomy. The pathological diagnosis included insulinoma in 11, nonfunctional islet-cell tumor in 8, mueinous cystadenoma in 9 and serous cystadenoma in 1.8 out of 17 patients with somatostatin analogue postoperatively had pancreatic leak, while 7 out of 12 patients without somatostatin analogue had pancreatic leak. There was no significantly different between these two groups （P 〉0.05）. The lasting time of pancreatic leak was 8.5 versus 20 days in patients with and without somastatatin （P 〈0.05）. [ Conclusion ] For benign tumors of the neck and body of the pancreas, enucleation or central pancreatectomy is the reasonable surgical option. Somatostatin analogue can not prevent the patients from pancreatic leak, but can shorten the lasting time of it.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第17期2136-2138,共3页
China Journal of Modern Medicine
