胰管结石合并胰腺癌的诊断和外科治疗

目的总结胰管结石合并胰腺癌的诊断及治疗经验。方法回顾性分析8例胰管结石合并胰腺癌患者的临床资料。结果男性5例，女性3例。6例有慢性胰腺炎病史，3例有酗酒史，1例有糖尿病史。主要症状为上腹痛、背痛及黄疸。影像学显示胰腺肿大、胰管扩张、胰腺结石或胰腺钙化。5例患者行胰十二指肠切除术，3例行胰体尾、脾脏切除、头颈段胰管取石术，其中2例附加胰空肠Roux-en-Y吻合术，1例附加残胰管置管外引流。结论胰管结石是胰腺癌的重要致病因素，胰管结石并发胰腺癌诊断困难。影像学检查及细针穿刺细胞学检查是诊断胰管结石合并胰腺癌的主要手段。胰管结石合并胰腺癌病人应争取及早手术治疗，胰十二指肠切除术为首选术式。

Diagnosis and surgical therapy of pancreatic duct stones associated with pancreatic cancer

Objective To summarize the diagnostic and therapeutic experience of pancreatic duct stones associated with pancreatic cancer. Methods Eight cases of pancreatic duct stones associated with pancreatic cancer were analyzed retrospectively.Results 5 men and 3 women.3 cases of whom had excessive drinking,6 cases had chronic pancreatitis,and 1 case had diabetes mellitus, chief symptoms included abdominal and back pain and jaundice.Image showed dilatation of pancreatic duct with stone or calcification and enlargement of pancreas. 5 patients were subjected to pancreaticoduodenectomy. 3 patients underwent pancreatic body-tail resection, splenectomy and pancreatolithotomy, of which 2 patients were added to Roux-en-Y pancreaticojejunostomy, 1 patient needed a set external drainage in residue pancreatic duct. Conclusion Pancreatic duct stones is an important factor to beget pancreatic cancer and diagnosis of pancreatic duct stones associated with pancreatic cancer is difficult.Images and aspiration biopsy are primary diagnostic methods for pancreatic duct stones associated with pancreatic cancer. Patients with pancreatic duct stones associated with pancreatic cancer coincidence should perform operation as soon as possible. Pancreaticoduodenectomy is the first choice for surgical treatment.