中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (05): 432-434.

• 论著 • 上一篇    下一篇

胰头良性病变的外科治疗

迟永兴,周建平,董    明,李昱骥,孔凡民,田雨霖   

  1. 中国医科大学附属第一医院普通外科教研室胃肠外科,辽宁沈阳 110001
  • 出版日期:2011-05-01 发布日期:2011-05-30

  • Online:2011-05-01 Published:2011-05-30

摘要:

目的    探讨胰头良性病变的外科治疗方式。 方法    分析中国医科大学附属第一医院自1995年8月至2009年8月手术治疗的22例胰头良性病变病人的临床资料。结果    22例中实性假乳头状瘤5例,浆液性囊腺瘤5例,黏液性囊腺瘤4例,慢性胰腺炎 3例,无功能胰岛细胞瘤3例,导管内乳头状黏液瘤1例,胃泌素瘤 1例。均经手术治疗,10例行胰十二指肠切除术,7例行保留十二指肠的胰头切除术,5例行肿物摘除术。胰十二指肠切除术10例中3例发生胰瘘,保留十二指肠的胰头切除术7例中1例发生胰瘘,肿物摘除术5例中3例发生胰瘘。20例病人获得随访,18例病人健在,2例因其他疾病死亡。结论    对于胰头良性病变,应该选择保留十二指肠的胰头切除术或肿物摘除术。

关键词: 胰腺, 良性病变, 保留十二指肠的胰头切除术

Abstract:

Surgical treatment of benign lesions of head of the pancreas: a report of 22 cases        CHI Yong-xing, ZHOU Jian-ping, DONG Ming, et al. Department of General Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author: DONG Ming, E-mail:mingdong@mail.cmu.edu.cn
Abstract    Objective    To investigate surgical option of benign lesions of head of the pancreas. Methods    The clinical data of 22 cases of benign lesions of head of the pancreas performed surgery from August 1995 to August 2009 at the First Hospital of China Medical University were analyzed. Results  The pathological diagnosis included solid-pseudopapillary tumor in 5 cases, serous cystadenoma in 5 cases, mucinous cystadenoma in 4 cases, chronic pancreatitis in 3 cases, nonfunctional islet-cell tumor in 3 cases, intraductal papillary mucinous tumor in 1 case and gastrinoma in 1 case.The operation procedures included pancreatoduodenectomy (PD) in 10 cases, duodenum-preserving pancreatic head resection(DPPHR) in 7 cases and enucleation in 5 cases. Pancreatic leakage was occurred in 3 out of 10 cases with PD, 1 out of 7 cases with DPPHR, and 3 out of 5 cases with enucleation. Twenty cases were followed up with 18 cases alive and 2 cases dying of unrelated diseases. Conclusion    For benign lesions of head of the pancreas, DPPHR or enucleation is the reasonable surgical option.

Key words: pancreas, benign lesions, duodenum-preserving pancreatic head resection