目的    对胰腺浆液性囊腺瘤的诊断与治疗相关问题进行分析。方法    对中国医科大学附属第一医院普通外科2006年4月至2012年4月收治的20例胰腺浆液性囊腺瘤病人的临床资料进行回顾性分析。结果    20例病人中，男6例，女14例。肿瘤位于胰头部5例，胰体及胰体尾部15例。瘤体平均直径5.7 cm。临床表现为上腹隐痛不适15例，其中腹痛伴腹胀8例，包括轻度恶心2例、黄疸1例。超声和CT检查均发现病灶并准确定位。20例均行手术治疗。1例行保留十二指肠的胰头切除术，4例行胰十二指肠切除术，2例行胰腺中段切除术，7例行胰体尾脾切除术，6例行保留脾脏的胰体尾切除术。5例术后发生胰瘘及腹腔感染，经非手术治疗均治愈。无围手术期死亡病例，随访时间12～79个月，中位随访39.5个月，均无肿瘤复发。结论    超声、CT是胰腺浆液性囊腺瘤主要的影像学检查方法，可早期准确的发现及定位病灶。难以定性的胰腺囊性肿瘤应行手术治疗，手术应按良性肿瘤手术原则，尽量保留器官，减少手术创伤。胰腺浆液性囊腺瘤预后良好。

Analysis of diagnosis and treatment of 20 cases of pancreatic serous cystadenoma        ZHANG Lei, WANG Ke-wei,KONG Fan-min，et al. Department of Gastrointestinal Surgery,the First Affiliated Hospital,China Medical University,Shenyang 110001,China
Corresponding author:KONG Fan-min, E-mail:kong_fanmin@yahoo.com.cn
Abstract    Objective    To investigate the diagnosis and treatment of serous cystadenoma of the pancreas.  Methods The clinical data of 20 patients with serous cystadenoma of the pancreas which were admitted into the First Hospital of China Medical University from April 2006 to April 2012 were retrospectively analyzed. Results    There were 6 males (30%) and 14 females(70%).Tumors were present in the pancreatic body and tail in 15 cases,in the pancreatic head in 5 cases.The mean diameter of the tumor was 5.7cm. The clinical manifestations of upper abdominal discomfort 15 cases,abdominal pain and bloating 8 cases, including mild nausea 2 cases, jaundice 1 case. Ultrasound and CT lesion detection rate was 100%, the ultrasound localization rate 83.3%, CT 100%. All 20 patients received surgical resection. Duodenum-preserving pancreatic head resection in 1 case,pancreaticoduodenectomy was performed in 4 cases, central pancreatectomy in 2 case, distal pancreatectomy with splean in 7 cases, and spleen preserving distal pancreatectomy in 6 cases. Postoperative pancreatic fistula and intra-abdominal infections developed in 5 cases,Fistula was healed by conservative therapy in all these 5 cases. No perioperative deaths, postoperative followed up from 12 to 79 months,The median survival time 39.5 months.Found no recurrence. Conclusions    Ultrasound and CT was main imaging examination for serous cystadenoma of the pancreas,and Accurate early detection and positioning lesions,Surgical resection should be adopted for serous cystadenoma of the pancreas with uncertain malignancy. Surgery should be benign surgical principles, try to retain the organs, reduce surgical trauma, serous cystadenoma prognosis is good.