Diagnosis and Surgical Treatment for 19 Cases of Pancreatic Cystic Neoplasm_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

郝建朋 , 姚俊超 , 郭大伟 , 孙文郁 , 梁健 ,  姜晓峰

Corresponding author：

姜晓峰, Email: jxf0426@hotmail.com

Keywords：

胰腺囊性肿瘤; 诊断; 外科治疗

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目的　探讨胰腺囊性肿瘤的诊断及外科治疗方法。
方法　对我院2003年4月至2012年4月期间收治的19例胰腺囊性肿瘤患者的临床资料进行回顾性分析。
结果　本组19例患者中浆液性囊腺瘤8例，黏液性囊腺瘤5例，导管内乳头状黏液瘤4例，实性假乳头状瘤1例，囊腺癌1例。行B超或CT发现胰腺占位病变。位于胰头部5例，胰体部8例，胰尾部6例。行肿瘤摘除术4例，保留脾脏的胰体尾切除术5例，胰体尾＋脾脏切除手术3例，胰十二指肠切除术6例，1例囊腺癌患者因肝脏转移伴腹腔广泛转移、侵犯大血管而肿瘤不能切除仅行胃空肠、胆肠吻合。术后发生胰瘘2例，腹腔感染1例，经保守治疗后康复出院。无围手术期死亡病例。19例患者均进行了随访，随访时间6～80个月，平均45.2个月。1例囊腺癌合并肝脏转移患者于术后7个月死亡，其余良性肿瘤患者均未见复发，最长已存活5年。
结论　胰腺囊性肿瘤主要靠影像学检查发现，手术切除是理想的治疗方法，选择合适的术式有助于避免术后并发症的发生和改善预后。

Citation： 郝建朋,姚俊超,郭大伟,孙文郁,梁健,姜晓峰. Diagnosis and Surgical Treatment for 19 Cases of Pancreatic Cystic Neoplasm. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(11): 1295-1297. doi: Copy

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2.	Farrell JJ， Fernández-del Castillo C. Pancreatic cystic neoplasms：management and unanswered questions[J]. Gastroenterology， 2013， 144(6)：1303-1315.
3.	de Jong K， van Hooft JE， Nio CY， et al. Accuracy of preoperative workup in a prospective series of surgically resected cystic pancreatic lesions[J]. Scand J Gastroenterol， 2012， 47(8-9)：1056-1063.
4.	Lee LS， Clancy T， Kadiyala V， et al. Interdisciplinary management of cystic neoplasms of the pancreas[J]. Gastroenterol Res Pract， 2012. doi：10. 1155/2012/513163.
5.	Scoazec JY， Vullierme MP， Barthet M， et al. Cystic and ductal tumors of the pancreas：diagnosis and management[J]. J Visc Surg， 2013， 150(2)：69-84.
6.	Lee SE， Kwon Y， Jang JY， et al. The morphological classification of a serous cystic tumor (SCT) of the pancreas and evaluation of the preoperative diagnostic accuracy of computed tomography[J]. Ann Surg Oncol， 2008， 15(8)：2089-2095.
7.	Curry CA， Eng J， Horton KM， et al. CT of primary cystic panc-reatic neoplasms：can CT be used for patient triage and treatment?[J]. AJR Am J Roentgenol， 2000， 175(1)：99-103.
8.	Tanaka M. Intraductal papillary mucinous neoplasm of the panc-reas：diagnosis and treatment[J]. Pancreas， 2004， 28(3)：282-288.
9.	Kim YI， Woo SM， Lee WJ， et al. Appropriate indications of initialendoscopic ultrasound evaluation for detecting mural nodules in branch duct intraductal papillary mucinous neoplasms of the panc-reas[J]. Scand J Gastroenterol， 2013， 48(5)：610-616.
10.	Wang DB， Wang QB， Chai WM， et al. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography[J]. World J Gastroenterol， 2009， 15(7)：829-835.
11.	Al-Rashdan A， Schmidt CM， Al-Haddad M， et al. Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience[J]. J Gastrointest Oncol， 2011， 2(4)：208-214.
12.	Beger HG， Siech M， Poch B. Duodenum-preserving total panc-reatic head resection：an organ-sparing operation technique for cystic neoplasms and non-invasive malignant tumors[J]. Chirurg，.
13.	Atiq M， Suzuki R， Khan AS， et al. Clinical decision making in the management of pancreatic cystic neoplasms[J]. Expert Rev Gastroenterol Hepatol， 2013， 7(4)：353-360.
14.	Konstantinou F， Syrigos KN， Saif MW. Intraductal papillary mucinous neoplasms of the pancreas (IPMNs)：epidemiology， diagnosis and future aspects[J]. JOP， 2013， 14(2)：141-144.
15.	Gálvez E， Gálvez G， Barboza A， et al. Pancreatic intraductal papillary mucinous neoplasm and recurrent pancreatitis[J]. Rev Gastroenterol Peru， 2013， 33(1)：66-74.
16.	， 84(5)：412-420.

1. Mori E， Yuen K， Medrano H， et al. Management of pancreatic cystic tumors in the Alberto Sabogal Sologuren hospital[J]. Rev Gastroenterol Peru， 2012， 32(2)：169-177.
2. Farrell JJ， Fernández-del Castillo C. Pancreatic cystic neoplasms：management and unanswered questions[J]. Gastroenterology， 2013， 144(6)：1303-1315.
3. de Jong K， van Hooft JE， Nio CY， et al. Accuracy of preoperative workup in a prospective series of surgically resected cystic pancreatic lesions[J]. Scand J Gastroenterol， 2012， 47(8-9)：1056-1063.
4. Lee LS， Clancy T， Kadiyala V， et al. Interdisciplinary management of cystic neoplasms of the pancreas[J]. Gastroenterol Res Pract， 2012. doi：10. 1155/2012/513163.
5. Scoazec JY， Vullierme MP， Barthet M， et al. Cystic and ductal tumors of the pancreas：diagnosis and management[J]. J Visc Surg， 2013， 150(2)：69-84.
6. Lee SE， Kwon Y， Jang JY， et al. The morphological classification of a serous cystic tumor (SCT) of the pancreas and evaluation of the preoperative diagnostic accuracy of computed tomography[J]. Ann Surg Oncol， 2008， 15(8)：2089-2095.
7. Curry CA， Eng J， Horton KM， et al. CT of primary cystic panc-reatic neoplasms：can CT be used for patient triage and treatment?[J]. AJR Am J Roentgenol， 2000， 175(1)：99-103.
8. Tanaka M. Intraductal papillary mucinous neoplasm of the panc-reas：diagnosis and treatment[J]. Pancreas， 2004， 28(3)：282-288.
9. Kim YI， Woo SM， Lee WJ， et al. Appropriate indications of initialendoscopic ultrasound evaluation for detecting mural nodules in branch duct intraductal papillary mucinous neoplasms of the panc-reas[J]. Scand J Gastroenterol， 2013， 48(5)：610-616.
10. Wang DB， Wang QB， Chai WM， et al. Imaging features of solid pseudopapillary tumor of the pancreas on multi-detector row computed tomography[J]. World J Gastroenterol， 2009， 15(7)：829-835.
11. Al-Rashdan A， Schmidt CM， Al-Haddad M， et al. Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience[J]. J Gastrointest Oncol， 2011， 2(4)：208-214.
12. Beger HG， Siech M， Poch B. Duodenum-preserving total panc-reatic head resection：an organ-sparing operation technique for cystic neoplasms and non-invasive malignant tumors[J]. Chirurg，.
13. Atiq M， Suzuki R， Khan AS， et al. Clinical decision making in the management of pancreatic cystic neoplasms[J]. Expert Rev Gastroenterol Hepatol， 2013， 7(4)：353-360.
14. Konstantinou F， Syrigos KN， Saif MW. Intraductal papillary mucinous neoplasms of the pancreas (IPMNs)：epidemiology， diagnosis and future aspects[J]. JOP， 2013， 14(2)：141-144.
15. Gálvez E， Gálvez G， Barboza A， et al. Pancreatic intraductal papillary mucinous neoplasm and recurrent pancreatitis[J]. Rev Gastroenterol Peru， 2013， 33(1)：66-74.
16. ， 84(5)：412-420.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Surgical Treatment for 19 Cases of Pancreatic Cystic Neoplasm

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