十二指肠间质瘤的诊断与治疗探讨

目的探讨十二指肠间质瘤的临床诊断和治疗。方法回顾性分析1995年1月-2005年10月我院收治的13例十二指肠间质瘤的临床资料。结果本组病人以黑便和腹痛为主要临床症状,临床诊断需综合利用B超、CT、胃镜、内镜超声检查确定。肿瘤位于十二指肠降部9例,球部2例,水平部及升部各1例。肿瘤直径2.2-13.0 cm,平均5.7 cm。7例十二指肠降部肿瘤行胰十二指肠切除术,4例行肿瘤局部切除术,1例行远端胃大部切除术,1例行十二指肠节段切除术。1例术后3年半死于肝转移,1例术后5年复发死亡,其余病例已健康存活11个月-10年。结论十二指肠间质瘤恶性多见,应积极手术治疗,肿瘤完全切除可获良好预后。

DIAGNOSIS AND TREATMENT OF DUODENAL STROMAL TUMORS

Objective To study the diagnosis and treatment of duodenal stromal tumors. Methods A retrospective review was done in 13 patients with duodenal stromal tumors treated from 1995--2005. Results Melena and abdominal pain were their main symptoms. The diagnosis relied upon combination of sonography, CT, gastroscopy, and endoscopic ultrasonography. The tumors located at the descending part of duodenum （9/13）, at the bulb （2/13）, at the horizontal part （1/13） and ascending part （1/13）. The size （mean） of the tumor was 2.2-13.0 cm （5.7 cm）. Pancreaticoduodenectomy was done in seven cases with tumor located at the descending part, local resection done in four, and distal subtotal gastrectomy and segmental resection were done in one case, respectively. Follow-up of 11 months to 10 years showed one died of liver metastasis 3.5 years after operation and one died of recurrence five years postoperatively, others survived. Conclusion Most duodenal stromal tumors are malignant. A positive surgery is recommended as favorable prognosis is expected after complete removal of the tumor.