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目的研究胰腺实性假乳头状瘤的临床病理特点,总结诊断和治疗经验。方法回顾性分析中南大学湘雅医院普外科2002年1月至2010年11月间收治的16例经手术和病理证实的胰腺实性假乳头状瘤病例,研究其临床和病理资料,总结诊断和治疗经验。结果 16例病人中男2例,女14例,中位年龄30.2岁。其中6例呈实性,9例呈囊实性,1例呈囊性。16例中14例获得完整切除(R0)。手术方式包括胰体尾切除术9例(其中保脾手术5例),胰中段切除术3例,胰十二指肠切除术1例,胰体尾切除并胰头肿块局部切除术1例。2例未获切除。本组术后无一例住院期死亡,总的并发症率31.2%。随访显示获得完整切除的14例病人均无瘤存活。而2例未获切除者分别于术后1年和2年死亡。结论胰腺实性假乳头状瘤大多具有良性的生物学行为和良好预后。避免误诊和积极的手术态度是进一步提高疗效的关键。
Objective To study the clinicopathological features of solid pseudopapillary tumors of the pancreas and summarize the diagnosis and treatment experience. Methods Retrospective analysis of 16 cases of solid pseudopapillary pancreatic tumors confirmed by surgery and pathology from January 2002 to November 2010 in Department of General Surgery, Xiangya Hospital, Central South University from January 2002 to November 2010, to study the clinical and pathological data, to summarize the diagnosis and Treatment experience. Results There were 2 males and 14 females in 16 patients, the median age was 30.2 years. Six of them were solid, nine were cystic and one cystic. Fourteen of the 16 patients underwent complete resection (R0). Surgical methods included pancreatic body tail resection in 9 cases (of which spleen preservation surgery in 5 cases), pancreas resection in 3 cases, pancreatoduodenectomy in 1 case, pancreatic body tail resection and pancreatic head mass partial resection in 1 case. 2 cases were not removed. None of the patients died after hospitalization in this group, with a total complication rate of 31.2%. Follow-up showed that all 14 patients who received a complete resection had no tumor-free survival. However, 2 patients who did not undergo resection died at 1 year and 2 years respectively. Conclusion Most of the solid pancreatic pseudopapillary tumors have benign biological behavior and good prognosis. Avoid misdiagnosis and positive surgical attitude is the key to further improve the efficacy.