小儿胰腺肿瘤的诊断与治疗(附15例报告)

目的 探讨小儿胰腺肿瘤的诊断和治疗.方法 回顾性分析2002年1月至2010年1月收治的15例胰腺肿瘤,男8例,女7例；年龄45 d至17岁(平均11.3岁).临床表现:腹痛9例,2例合并黄疸；腹部包块6例.B超和CT检查均为胰腺占位性病变.手术方式:腹腔镜胰腺肿瘤切除术6例；胰腺体尾部切除术4例；肿瘤剔除术4例；Whipple术1例.结果 本组患儿无围手术期死亡.病理:胰腺实性乳头状瘤8例,胰腺母细胞瘤4例,胰腺血管瘤1例,胰腺无功能性内分泌癌1例,胰腺癌1例.术后随访1年至8年,患儿全部存活.14例未见复发和转移,1例胰腺癌化疗后2年肝转移,行转移瘤局部切除术后治愈.结论 小儿胰腺肿瘤罕见,临床多见胰腺实性乳头状瘤和胰腺母细胞瘤.腹腔镜和开腹根治性手术均可获得良好的治疗效果.胰腺癌根治性手术后易复发,需长期随访.

Diagnosis and management of pancreatic tumor in children ( 15 cases of report)

Objective To summarize the clinical characteristics of diagnosis and management of pancreatic tumor children.Methods Between January 2002 and 2010 January,total 15 patients suffering from pancreatic tumor underwent treatment in our centre.Their clinical data were retrospectively summarized and analyzed in this study.The mean age of all patients (male 8,female 7) was 11.3 years old (ranging from 45 d to 17 y).Clinical manifestations of them were listed as follows:9 of all have symptoms of abdominal pain,among them,2 children were associated with jaundice.Abdominal mass were found in 6 patients.The result of supersonic examination and CT scanning indicated a pancreatic occupation in all patients.In term of surgical procedures,6 patients underwent laparoscopic pancreatic body resections and local reactions using traditional open approach were taken in 4 patients,distal pancreatectomy was done in 4 patients and pancreatoduodenectomy was performed in 1 patients.Results No mortality was found in this study.The postoperative pathological results revealed pancreatic solid pseudopapillary tumor in 8 cases,pancreatoblastoma in 4 cases,1 pancreatic angioma and 1 non function islet tumor,as well as pancreatic cancer in 1 case.The fellow-up period ranged from 1 to 8 years,and all population survived.No recurrence and metastasis was found in 14 cases.The patient with pancreatic cancer was found a hepatic metastasis in second years after surgery,and underwent metastatic tumor resection.Conclusions Children pancreatic tumor is relatively rare in clinics.Solid pseudopapillary tumor and pancreatoblastoma are the commonest pathological type.The better curative efficacy will be taken for both laparoscopic and open approach radical resection.However,post-operative pancreatic cancer was liable to recur and metastasize,and long-term of fellow-up is still needed to evaluate the life quality in patients.