乏特氏乳头癌的诊断和治疗(附12例报告)

目的 探讨乏特氏乳头癌的诊断和治疗。方法 回顾性总结1985-1995年经手术及病理证实的12例乏特氏乳头癌的诊断和治疗经验。结果 12例患者术前影像学检查（B超、CT）均未能作出该病的直接诊断，而行纤维十二指肠镜检查的5例，均发现乳头肿瘤，活检证实4例为乳头腺癌，1例为乳头腺瘤（术后切片为腺瘤恶变），其余病例均在术中切开十二指肠降部行乳头肿块冰冻切片确诊，11例行胰十二指肠切除术，1例乳头部腺瘤癌变行乳头肿瘤局部切除术。结论 纤维十二指肠镜检查和ERCP有利于术前明确乏特氏乳头部肿瘤的诊断。

DIAGNOSIS AND THERAPY FOR CARCINOMA OF THE PAPILLA OF VATER(A REPORT OF 12 CASES)

Objective to summarize experience in diagnosis and therapy for carcinoma of the papilla of Vater.Methods The data of 12 cases of carcinoma of the papilla of Vater treated in our department from 1985 to 1995 were analyzed.All patients were diagnosed by operation and pathology.Results All patients had not the etiological diagnosis by preoperative image examination(ultrasonic examination,computed tomography).Five of them were found to have the papilla neoplasm by duodenal fibroscope.Among these,four cases were adenocarcinoma,one case was adenoma by preoperative biopsy.(Postoperative paraffon section test it adenoma cancerization),the others were confirmed by intraoperative papilla neopasm biopsy.Pancreato duodenectomy was operated in eleven,local excision was in adenoma cancerization.Conclusion Fibrodudenoscopy might assist to diagnose the carcinoma of the Vater's papilla preoperatively.