胰腺囊性肿瘤40例诊疗分析

目的探讨胰腺囊性肿瘤的诊治方法。方法对笔者所在医院科室2001年10月至2013年10月期间收治的40例胰腺囊性肿瘤患者的临床资料进行回顾性分析。结果胰腺囊性肿瘤无特殊临床表现，B超和CT检查对胰腺囊性肿瘤的诊断正确率分别为57．5％（23／40）和72．5％（29／40），但不能准确区分其组织学类型。40例患者均行手术治疗，其中2例患者误诊为假性囊肿而行内引流术，另外38例行胰体尾切除术。术后病理学检查证实浆液性囊腺瘤23例，黏液性囊腺瘤9例，导管内乳头状黏液性腺瘤3例，黏液性囊腺癌5例。5例失访，35例患者获随访，随访时间为（74．2±12．8）个月（2个月～8年）；3例囊腺癌患者中1例肿瘤切除者至今存活（已随访8年），2例肿瘤未切除者分别于术后4个月和7个月因肿瘤转移死亡；其余32例获访的囊腺瘤患者均存活至今。结论外科切除是治疗胰腺囊性肿瘤最有效的手段，即使是对于无任何症状的患者也应行积极的手术治疗。

Diagnosis and Treatment of 40 Cases of Pancreatic Cystic Neoplasms

Objective To investigate the diagnosis and treatment of pancreatic cystic neoplasm. Methods The clinical data of 40 cases of pancreatic cystic neoplasm from October 2001 to October 2013 in our hospital were retrospec- tively analyzed. Results Patients with pancreatic cystic neoplasm had no specific clinical feature. Ultrasonography and computed tomography displayed a cystic tumor in 57. 5% （23/40） and 72.5% （29/40） of all patients, respectively, but could not distinguish the histological types. All of the patients had been operated, among them 2 cases were misdia- gnosed as pseudocysts and internal drainage; another 38 patients were undergoing the distal pancreatectomy. Pathologic examination results after operation showed 23 cases of serous cystadenoma, 9 cases of mucinous cystadenoma, 3 cases of intraductal papillary mucinous adenoma, and 5 cases of mutinous cystadenocarcinoma. Thirty five patients were followed-up. The followed-up time range from 2 months to 8 years, verage （74.2＋_12.8） months. Among the 3 patients with mucinous cystadenocarcinoma, 1 patient alived with no evidence of recurrence, the other 2 patients died of tumor invasion and metastasis in 4 months and 7months after operation. The others were still alive now with no evidence of recurrence. Conclusion Surgical resection is the most effective treatment for pancreatic cystic tumor, even if the patients with no any symptoms.