胰腺实性假乳头状瘤47例临床诊治分析

目的探讨胰腺实性假乳头状瘤（solid pseudopapillary tumor,SPT）的临床病理特征与诊断、治疗及预后。方法对2006年1月～2011年12月我院47例SPT的临床表现、实验室和影像学检查、病理结果、治疗和预后进行回顾性分析。结果 45例行手术切除,其中胰十二指肠切除术11例、胰体尾＋脾切除术18例、胰尾切除术2例、胰腺中段切除术3例、肿瘤局部切除术9例、术后复发再次手术2例;开腹探查术2例。术后出现胰漏14例,胆漏2例,出血3例,腹腔感染3例,胃瘫4例。45例术后随访3～68个月,平均32个月,其中随访〉24个月29例,均未出现复发和转移,无死亡。结论胰腺SPT是一种低度恶性肿瘤,临床表现无特异性,CT及MRI是最主要的影像学检查方法,治疗以手术切除为主,预后良好。

Diagnosis and Treatment of Solid Pseudopapillary Tumor of the Pancreas:Analysis of 47 Cases

Objective To summarize and assess clinicopathologic characteristics of solid pseudopapillary tumors(SPT) of the pancreas,including the diagnosis,treatment and prognosis.Methods The medical records of 47 patients who underwent surgery for a pathologically confirmed SPT between January 2006 and December 2011 were reviewed retrospectively.Results Of the 47 patients,45 patients underwent surgical resection including 11 cases of pancreatoduodenectomy,2 cases of distal pancreatectomy,18 cases of distal pancreatectomy plus splenectomy,3 cases of middle pancreatectomy,9 cases of local resection,and 2 cases of recurrent surgery;abdominal exploration was performed in the other 2 patients.After the procedures,14 patients developed pancreatic leakage,2 had bile leakage,3 showed hemorrhage,3 developed intra-abdominal infection,and 4 had gastric paralysis.Follow-up was achieved in 45 cases for 3 to 68 months with a mean of 32 months(>24 months in 29 cases),during which no recurrence or metastasis were detected,and no patient died.Conclusions Solid pseudopapillary tumors of the pancreas are less aggressive without typical clinical features.CT and MRI are the main imaging examinations for the disease.Surgery is the first choice for its treatment.The prognosis of SPT is good.