胰腺肿瘤局部切除17例临床分析

目的 探讨局部切除术在胰腺肿瘤治疗中的作用.方法 回顾性分析中国医学科学院肿瘤医院1996年1月至2007年6月实施的17例胰腺肿瘤局部切除术的临床资料,包括诊断与手术过程.结果 肿瘤位于胰头9例、胰体7例、胰尾1例.肿瘤直径1.5～8.0 cm,平均3.6 cm,其中直径＞4 cm者8例.术后病理无功能胰岛细胞瘤8例,实性假乳头状瘤5例,神经鞘瘤1例,囊肿1例,间质瘤1例,低度恶性囊实性肿瘤1例.术后胰漏发生率41.2%,无手术死亡病例.无继发糖尿病、脂肪泻等胰腺内外分泌功能障碍;无肿瘤复发.结论 胰腺肿瘤局部切除术可以应用于胰腺良性及低度恶性肿瘤的外科治疗,可有效保留胰腺的内、外分泌功能,但胰漏的发生率较高,有待于进一步解决.

Local resection of pancreatic neoplagms: clinical analysis of 17 cases

Objecfive To evaluate the role of local resection in treatment of pancreatic neoplasms.nethods The clinical data of 17patients with pancreatic neoplasms,3 males and 14 females,aged 47.9(34-67),who underwent local resection from January 1996 to June 2007 were analyzed.Results Of the 17 tumors,9 were located in the head,7 located in the body,and 1 located in the tail of pancreas.The diameters of the 17 tumors were 1.5-8.0 cm,3.6 cm on average,and the diameters of 8 tumors were above 4 cm.Pathological examination confirmed 8 tumors as nonfunctioning insulinoma,5 as solid pseudopapillary tumor,1 as neurilemmoma,1 as cyst,1 as gastrointestinal stroma tumor,and 1 as lowgraded malignant tumor.Pancreatic leakage occurred in 7 cases(41.2%)and no death,recurrence,and endocrine and exocfine insufficiency occurred after operation.Conclusion Capable pf preserving endocrine and exocfine functions,local resection is a feasible method for benign or low-graded malignant pancreatic neoplasms,however,with a high rate of pancreatic leakage.