摘要:
Objective Explore ways of pathological features and diagnosis about pancreatic cystric tumors on clinical. Methods Retrospcdive analysis of pancreatic cystic tumor of 15 cases clinical data in 2004 -2009. Results There are 3 cases of serous eystadenomas and 7 of mucinous cystadenoma and 5 of cystadenocarcinoma in 15 patients. There are 5 cases of tumor located in the pancreatic head,l cases of tumor located in the pancreatic body,2 cases of tumor in the tail of pancreatic body, and 7 cases of tumor in the pancreatic tail, all of them received surgical treatment. There are 5 casses of pancrealicoduode-nal were removed, 1 pancreatic distal jejunum,4 tumor excision in the pancreatic tail,2 pancreatic tail,2 splenectomy and 1 liver metastases resection. The preoperative misdagnosis rate is about 26. 7% , the intraoperative misdiagnosis rate is about 20% ,no deaths happen during surgery a prognosis is good. Conclusion Surgical resection is the only effective treatment meth in treatment of pancreatic: cystic neoplasms.%目的 探讨胰腺囊性肿瘤的临床病理特点及诊治方法.方法 对2004~ 2009年我院收治的均经手术和病理检查证实为胰腺囊性肿瘤的15例临床资料进行回顾性分析.结果 15例病人中浆液性囊腺瘤3例,黏液性囊腺瘤7例,囊腺癌5例.浆液性囊腺瘤较黏液瘤和囊腺癌小(P<0.05).5例血清CAl99明显升高(胰腺囊腺癌4例,胰腺黏液性囊腺瘤1例)(正常参考范围1 ~ 39 u/L),提示CAl99是鉴别胰腺囊性肿瘤良恶性的较好标志物.5例肿物位于胰头部,1例肿物位于胰体部,2例肿物位于胰体尾部,7例肿物位于胰尾部.全部病人均接受了手术治疗.肿物位于胰头者行胰、十二指肠切除术5例;肿物位于胰体者行胰腺节段切除加胰腺远端空肠Roux-en-Y吻合术1例;肿物位于胰体尾者行肿物摘除术2例;肿物位于胰尾者行肿物摘除术2例,胰体尾切除术2例,胰体尾及脾切除术2例,胰体尾切除、脾切除及肝转移瘤切除术1例.与病理诊断相比,术前诊断误诊率26.7%,手术术中诊断误诊率20%.全组无围手术期死亡者,预后良好.结论 临床中胰腺囊性肿瘤的病史询问,病理学特征,B超及CT检查,囊液分析及组织活检有助于明确诊断,手术切除是唯一有效的治疗方法,疗效满意.