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患者男性,64岁。因上腹隐痛4个月,发现包块1个月入院。体检:Bp17/11 kPa,上腹偏左饱满,触及境界不清的包块,质中硬,活动差,轻压痛。B超示:左上腹膜后肿瘤,不排除胰体尾肿瘤。CT报告:胰体尾肿瘤。在插管麻醉下剖腹探查:见胰体尾后有巨大实质性肿块,活动度差,表面欠光滑,有包膜,布满蚯蚓状扩张血管。肿块与腹腔动脉分支、结肠系膜根部粘连。手术先分离肿块上下粘连,在脾动脉起始部结扎切断,游离脾脏和肿块左后,再在胰体近颈部处横断,游离肿块右后,切除整个
The patient is male, 64 years old. Due to pain in the upper abdomen for 4 months, he was admitted to hospital for 1 month. Physical examination: Bp17/11 kPa, left upper abdomen full, touched unclear mass, quality hard, poor activity, light tenderness. B-show: left upper retroperitoneal tumors, pancreatic body and tail tumors are not excluded. CT report: pancreatic body and tail tumor. Under the anesthesia intubation anesthesia exploration: see pancreatic body after the tail has a huge solid mass, poor activity, the surface is less smooth, there is a capsule, covered with sacral dilation of blood vessels. The masses adhered to the celiac artery branches and the mesenteric roots. Surgical separation of the upper and lower adhesions of the tumor was first performed by ligation at the beginning of the splenic artery, freeing of the spleen and the left mass, and then transection at the pancreatic body near the neck. After the free mass was removed, the entire area was resected.