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目的 探讨十二指肠间质瘤的临床特征及外科治疗效果。 方法 回顾性分析我科 1990~2004年 14例十二指肠间质瘤的临床资料。 结果 病理类型:良性 2例,潜在恶性 4例,恶性 8例。50 0% (7 /14)发生在降部,其中恶性占57 1% (4 /7)。临床表现为右上腹肿物(6 /14),右上腹隐痛不适(5 /14)和乏力、体重下降(3 /14),诊断手段为十二指肠低张造影(13 /14)、B超(13 /14)和CT(9 /14)。肿瘤距离十二指肠大乳头<3cm或位于降部、直径≥5cm者宜行胰十二指肠切除术,肿瘤距离十二指肠大乳头>3cm及较小者宜行十二指肠节段性切除术。 结论 十二指肠间质瘤恶性多见,临床表现无特异性,主要依靠十二指肠低张造影、B超、CT、EUS确诊,对无远处转移的肿瘤应积极争取根治性切除。
Objective To investigate the clinical features and surgical treatment of duodenal stromal tumors. Methods The clinical data of 14 cases of duodenal stromal tumors in our department from 1990 to 2004 were retrospectively analyzed. Results Pathological type: benign in 2 cases, 4 cases of potential malignant, malignant in 8 cases. 50 0% (7/14) occurred in the descending part of which 571% (4/7) were malignant. The clinical manifestations were right upper quadrant tumor (6/14), right upper quadrant pain and discomfort (5/14) and fatigue, weight loss (3/14), diagnosis of duodenal low contrast radiography (13/14), B Ultra (13 of 14) and CT (9 of 14). Tumor from the duodenal large nipple <3cm or located in the descending part of diameter ≥ 5cm should be pancreaticoduodenectomy, the tumor from the duodenal large nipple> 3cm and smaller should be OK duodenal section Segmental excision. Conclusions Duodenal stromal tumors are more common and their clinical manifestations are nonspecific. The diagnosis mainly depends on duodenal low contrast radiography, B ultrasound, CT and EUS. Radical resection should be actively pursued for tumors without distant metastasis.