无症状胰腺肿瘤的诊断与治疗

目的:探讨无症状胰腺肿瘤的诊断与治疗经验。方法:回顾性分析意外发现的无症状胰腺肿瘤的临床资料。结果:本组38例,男14例,女24例。肿瘤位于胰头者17例,胰体尾者21例。所有病例均行手术切除,包括胰十二指肠切除术11例,保留十二指肠的胰头切除术3例,肿瘤局部切除术1例,节段性胰腺切除术8例,胰体尾、脾切除术15例。术后病理:胰腺导管癌5例,无功能胰岛细胞瘤13例(其中2例恶性),浆液性囊腺瘤8例,黏液性囊腺瘤8例,囊腺癌1例,恶性胰腺导管内乳头状黏液性肿瘤2例,胰腺实性假乳头状瘤1例。恶性肿瘤共10例,占26.3%(10/38)。随访表明,除3例胰体癌术后6个月后死于肝转移外,其余已健康生存11个月～8年至今。结论:无症状胰腺肿瘤大部为良性肿瘤,部分为恶性肿瘤,应予积极手术治疗。手术切除率高,预后良好。

Diagnosis and treatment of asymptomatic pancreatic tumors

Objective To investigate the diagnosis and surgical treatment of asymtomatic pancreatic tumors. Methods A retrospective clinical analysis was made in 38 cases of asymtomatic pancreatic tumors admitted during the period of 1995 to 2004. Results There were 14 men and 24 women in the series, with a mean age of 50.2 years. All the patients were treated by pancreatoduodenectomy in 11, duodenum-preserving pancreatic head resection in 3, local excision of tumor in 1,segmental pancreatectomy in 8, distal pancreatectomy in 15. Histopathology: nonfunctioncal neuroendorine tumors, 13 cases; serous cystadenoma, 8 cases; mucinous cystadenoma or cystadenocarcinoma, 9 cases; malignant intraductal papillary mucinous tumors, 2 cases; solid-peudopapilliary tumor, 1 cases; ductal carcinoma, 5 cases; overall, a malignancy rate of 26.3%. Conclusions Our findings suggested that nearly three quarters of the asymtomatic pancreatic tumors were benign, but still a noticeable percentage were malignant which should also be considered favorably for surgical resection.