中国实用外科杂志

中国实用外科杂志

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剜除术治疗低级别无功能小胰腺神经内分泌肿瘤26例疗效分析

陈文祺，张    磊，王环宇，毛威麟，韩    序，吴文川，匡天涛，王单松，靳大勇，楼文晖，许雪峰   

  1. 复旦大学附属中山医院普外科，上海 200032
  • 出版日期:2020-02-01 发布日期:2020-02-14

  • Online:2020-02-01 Published:2020-02-14

摘要： 目的    探讨剜除术对低级别（G1、G2）无功能小（直径≤2 cm）胰腺神经内分泌肿瘤病人术后并发症和预后的影响。 方法    回顾性分析复旦大学附属中山医院普外科2009年1月至2018年12月收治的26例低级别（G1、G2）无功能小（直径≤2 cm）胰腺神经内分泌肿瘤病人的临床及随访资料。结果    26例病人均行胰腺肿瘤剜除术，手术时间（123.4±40.3）min，术中平均出血量（83.8±80.6）mL，术后共有7例（26.9%）病人发生胰瘘，其中3例（11.5%）为A级胰瘘，4例（15.4%）为B级胰瘘，术后平均住院时间为（12.2±8.9）d。术后随访6～119个月，平均随访时间64个月，1例失访，其余25例获得完整随访资料的病人均生存，其中1例病人于术后26个月发现肝转移，1例病人于术后29个月复发。 结论    剜除术治疗低级别无功能小胰腺神经内分泌肿瘤疗效确切，预后较好，但其远期预后仍需更长时间的远期随访结果验证。

关键词: 胰腺神经内分泌肿瘤, 剜除术, 术后并发症

Abstract: Enucleation for low-grade small non-functional pancreatic neuroendocrine tumors:An anlysis of 26 cases                   CHEN Wen-qi, ZHANG Lei, WANG Huan-yu, et al. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Corresponding author: XU Xue-feng, E-mail: xu.xuefeng@zs-hospital.sh.cn
Abstract    Objective    To investigate the clinical effect of enucleation on postoperative complications and prognosis in patients with low-grade (G1, G2) small (≤2cm) non-functional pancreatic neuroendocrine tumors. Methods    The clinical data of 26 patients underwent enucleation from January 2009 to December 2018 in the Zhongshan Hospital of Fudan University were analyzed retrospectively. Results    Enucleation were performed in all 26 patients. The average operation time was (123.4±40.3) min, and the average blood loss was (83.8±80.6) mL. Postoperative pancreatic fistula was observed in 7 patients (26.9%) including 3 grade A and 4 grade B pancreatic fistula (11.5% and 15.4% respectively) and all the patients recovered after conservative treatment. The postoperative hospital stay was (12.2±8.9) days. The follow-up period ranged from 6 to 119 months, with an average follow-up of 64 months. One patient was lost to follow-up and the other patients were all alive. Liver metastases were found in one patient 26 months after surgery while recurrence happened in another patient 29 months after surgery. Conclusion    Enucleation is effective in the treatment of patients with low-grade small non-functional pancreatic neuroendocrine tumors yet the long-term prognosis still needs to be verified by long-term follow-up.

Key words: pancreatic neuroendocrine tumors, enucleation, postoperative complication