胰头肿块型慢性胰腺炎的临床分析

目的探讨胰头肿块型慢性胰腺炎的诊治方法。方法对我院近10年38例胰头肿块型慢性胰腺炎的临床资料进行回顾性分析。结果本组病例主要症状为上腹部疼痛(100%)、黄疸(47.4%)和体重明显下降(42.1%),B超检查阳性率94.1%,CT、ERCP和MRCP阳性率均为100%。症状较轻,或因并存严重并发症的8例和病理切片排除恶性病变的5例行内科综合治疗,症状严重行胰头十二指肠切除16例,胆管空肠吻合5例、胰管空肠吻合1例,囊肿空肠吻合3例。结论本病诊断主要依靠影像学检查。症状较轻,可行内科治疗。症状严重,发生胆胰管梗阻或不能排除恶性病变者应行胰头十二指肠切除手术为主。

Clinical analysis of chronic pancreatitis with mass

Objective To investigate the diagnosis and treatment of chronic panereatitis(CP) with mass.Methods The clinical features of 38 cases of chronic pancreatitis with mass during the past ten years were retrospectively reviewed.Results The symptoms of these cases were tenderness(100%),jaundice(47.4%) and apparent weight loss(42.1%).The positive rate of B ultrasound examination was 94.1%,and that of CT、ERCP and MRCP were all 100%.Those with lightly symptom,or with severe complications(8 cases) and pathological biopsies to exclude a malignant lesion(5 cases) were treated with medical treatment,while whipple’s procedure(16 cases),Roux hepaticojejunostomy(5 cases),Pancreaticojejunostomy(1 cases) and Cyst jejunum anastomosis(3 cases) were performed in those with seriously symptom.Conclusions The diagnosis of CP with mass mainly depend on image examinations.If the symptom is light,it could be treated with medical care.If the symptoms are seriously,or with bile duct obstruction and cannot exclude a malignant lesion,it should be treated with whipple procedure.