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目的总结胰管结石合并胰腺癌的诊断及治疗经验。方法回顾性分析8例胰管结石合并胰腺癌患者的临床资料。结果男性5例,女性3例。6例有慢性胰腺炎病史,3例有酗酒史,1例有糖尿病史。主要症状为上腹痛、背痛及黄疸。影像学显示胰腺肿大、胰管扩张、胰腺结石或胰腺钙化。5例患者行胰十二指肠切除术,3例行胰体尾、脾脏切除、头颈段胰管取石术,其中2例附加胰空肠Roux-en-Y吻合术,1例附加残胰管置管外引流。结论胰管结石是胰腺癌的重要致病因素,胰管结石并发胰腺癌诊断困难。影像学检查及细针穿刺细胞学检查是诊断胰管结石合并胰腺癌的主要手段。胰管结石合并胰腺癌病人应争取及早手术治疗,胰十二指肠切除术为首选术式。
Objective To summarize the diagnosis and treatment experience of pancreatic duct stones with pancreatic cancer. Methods The clinical data of 8 patients with pancreatic duct stones complicated with pancreatic cancer were retrospectively analyzed. Results There were 5 males and 3 females. Six patients had a history of chronic pancreatitis, three had a history of alcoholism, and one had a history of diabetes. The main symptoms are upper abdominal pain, back pain and jaundice. Imaging showed pancreatic enlargement, pancreatic duct dilatation, pancreatic stones or pancreatic calcification. Five patients underwent pancreaticoduodenectomy. Three patients underwent pancreatic body and tail spleenectomy, and head and neck pancreatic duct lithotripsy. Two of them included an Roux-en-Y anastomosis of the pancreatic jejunum, and one had a residual pancreatic duct. External drainage. Conclusion Pancreatic duct stones are important pathogenic factors of pancreatic cancer. Pancreatic duct stones complicated with pancreatic cancer are difficult to diagnose. Imaging examination and fine-needle aspiration cytology are the main methods for the diagnosis of pancreatic duct stones and pancreatic cancer. Patients with pancreatic duct stones associated with pancreatic cancer should strive for early surgical treatment. Pancreatoduodenectomy is the preferred surgical procedure.