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胰腺囊性肿瘤大部分为良性,部分为恶性或有恶变及转移潜能。术前肿瘤类型及良恶性的判断是决定治疗方案的关键因素,关于囊性肿瘤的手术时机和手术方法,国内外一直存有争论,尤其对于分支胰管型的导管内乳头状黏液腺瘤的处理争议最大。由于此类肿瘤少见,目前国际上仍无关于胰腺囊性肿瘤的基于循证医学的指南。对于浆液性囊腺瘤,因绝大部分为良性,极少数为低度恶性,应严格把握手术指征;对于黏液性囊腺瘤、主胰管型导管内乳头状黏液腺瘤、实性假乳头状瘤虽可为良性,但有恶性潜能或已恶变,应尽早手术切除;分支胰管型的导管内乳头状黏液腺瘤因对其恶变潜能及恶变的临界点不确定,手术及时机争论颇多。因胰腺囊性肿瘤谱从良性、不典型增生、原位癌至恶性分布不等,手术方式亦从较小的囊腺瘤剥除至胰十二指肠切除术不等。
Pancreatic cystic tumors are mostly benign, some are malignant or malignant and metastatic potential. Preoperative tumor type and benign and malignant judgment is to determine the key factors of treatment options, the timing of surgery and cystic tumor surgery methods, there has been controversy at home and abroad, especially for the branch pancreatic ductal papillary mucinous adenoma Deal with the most controversial. Due to the rare occurrence of such tumors, there is currently no evidence based medicine guideline for pancreatic cystic tumors in the world. For serous cystadenoma, because most of the benign, a very small number of low-grade malignant, surgical indications should be strictly controlled; for mucinous cystadenoma, the main pancreatic ductal papillary mucinous adenoma, solid leave Although papilloma may be benign, but has malignant potential or has malignant transformation should be as soon as possible; Branch pancreatic ductal papillary mucinous adenoma because of its malignant potential and malignant transformation of the critical point uncertainties, surgery and timing controversy A lot. Because of pancreatic cystic tumor spectrum from benign, atypical hyperplasia, carcinoma in situ to the distribution of malignant, surgical methods also from small cystadenoma to pancreaticoduodenectomy unequal.