胰腺囊性肿瘤与假性胰腺囊肿的鉴别诊断

目的：提高对胰腺囊性肿瘤诊断的认识，减少这种少见肿瘤的误诊误治。方法：对上海中山医院1958年4月～1995年7月经病理证实的15例胰腺囊性肿瘤病人进行回顾性分析，并与1962年9月～1995年7月收治的76例假性胰腺囊肿病人的临床表现和辅助检查特点进行比较。分析误诊的原因，探讨鉴别诊断的方法。结果：15例胰腺囊性肿瘤中，仅有6例（40％）术前明确诊断为胰腺囊性肿瘤，其余9例（60％）术前被误诊为胰腺假性囊肿或中上腹肿块而行手术，其中7例术中被诊为囊性肿瘤而获相应的根治性切除，另2例被错误地进行了内引流术．结论：胰腺囊性肿瘤非常少见，其临床特征、影象学表现与假性胰腺囊肿相似而常导致误诊。但只要综合运用病史分析、影象学特点、囊液分析、术中活检、术中和术后观察等方法，就能提高诊断的准确率。

Differential diagnosis of pancreatic cystic tumors and pseudocysts

Objectives:To improve the understanding of cystic tumor of pancreas and to avoiddiagnostic errors and mal-management. Methods:We retrospectively studied 15 patients withpathologically confirmed cystic tumors of pancreas who were treated in our hospital from April1958 to July 1995, and compared these with 76 pseudocysts who were treated from Sept. 1962 to July1995 with regard to clinical and imaging diagnostic features. Results:Of all the 15 patients, only 6were definitely diagnosed as cystic tumor preoperatively, and the other 9 patients were mistakenfor pseudocysts or upper abdominal mass. Seven of them were diagnosed during operation andcurative resection was made, whereas the other 2 received improper internal drainage. Conclusions:Cystic tumors of pancreas are rare clinically. It is often misdiagnosed as pseudocysts, carefulinquiry into the history and careful differentiation of imaging features would lead to correctpreoperative diagnosis.