胰头肿块型慢性胰腺炎12例诊治分析

目的分析胰头肿块型胰腺炎的诊治方法。方法回顾性分析我院1998年6月至2008年6月间收治的125例慢性胰腺炎病例，总结其中12例因胰头占位而行胰十二指肠切除术患者的病例。结果12例患者术中探查均显示肿块位于胰头，与周围组织有粘连，其中1例与门静脉有粘连，但尚能剥离，术后病理证实均为慢性胰腺炎。结论目前区分慢性胰腺炎与胰腺癌尚无特异性好和敏感性高的鉴别方法，CT结合经内镜逆行胰胆管造影对大部分病例的鉴别诊断具有较高的价值，胰头肿块型胰腺炎行胰头十二指肠切除术治疗效果良好。

Diagnosis and treatment of chronic pancreatitis with mass in the head of the pancreas

Objective To summarize the experience in diagnosis and treatment of chronic panereatitis with mass in the head of the pancreas. Methods A total of 125 patients with chronic panereatitis treated from June 1998 to June 2008 were reviewed. Twelve cases received Whipple procedure because of difficult preoperative differential diagnosis between pancreatic cancer and chronic pancreastitis. Results The operation exploration showed that the mass was located in the head of the pancreas. Twelve patients had around-tissue adhesion and 1 single adhesion with vena portae. Pathological examination indietated that 12 patients suffered from chronic pancreatitis. Conclusions ERCP in combination with CT is the most sensitive method for distinguishing a neoplasm from chronic pancreatitis. Whipple procedure is a good approach for treatment of chronic panereastifis.