胰管结石合并胰腺癌的诊治

目的 探讨胰管结石与胰腺癌的关系及诊断与治疗的方法。方法 回顾性总结1990－1999年6月收治的5例胰管结石合并胰腺癌病人的临床资料。5例病人均行手术治疗，胰十二指肠切除3例，胰管切开取石、胰管空肠吻合1例，术中活检1例。结果 胰管结石病人多以上腹痛为首发症状。术前B型超声、ERCP、CT等都对胰石有确诊作用。胰腺癌在局部形成包块前，术前诊断较为困难。结论 B型超声为诊断胰管结石的首选检查法；胰管结石易合并胰腺癌，术中应常规行病理检查。胰管结石合并胰腺癌病人的首选术式为胰十二指肠切除术。

Diagnosis and treatment of pancreatolithiasis complicated with pancreatic cancer

Objective To study the relationship between diagnosis and treatment of pancreatolithiasis and pancreatic cancer. Methods Five cases of pancreatolithiasis with pancreatic cancer surgically treated in our hospital from 1990 to 1999 were reviewed. Of these 5 patients, 3 were subjected to pancreaticoduodenectomy, 1 pancreaticolithotomy and pancreaticojejunostomy and the other biopsy during the operartion. Results The major symptom was abdominal pain. The disease cold be correctly diagnosed by B mode untrasonography, ERCP and CT. ERCP was very important for diagnosis of the disease. Before the pancreatic mass was found, pancreatolithiasis with pancreatic cancer was difficult to be correctly diagnosed. Conclusions B mode ultrasonography is the best choice for diagnosis of pancreatolithiasis. Pancreatolithiasis is apt to be combined with pancreatic cancer. Pathological examination is necessary during the operation. Pancreaticoduodenectomy is of the first choice in treatment of pancreatolithiasis with pancreatic cancer.