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十二指肠绒毛状肿瘤的发病率逐见增加,1981年总结了73例,1989年总结了161例.作者收集了1974～1992年法国19个外科部门所治疗的47例十二指肠绒毛状肿瘤,不包括长自壶腹部、胆道或胰腺侧的肿瘤.全组中,男性占21例,女性26例,平均年龄61.6±12.3岁.随访中位值46月 (16～314月).6例原有消化道癌,4例有十二指肠溃疡史,2例有家族性结肠息肉病,1例有Gardner综合征.临床表现以腹痛(47%)、消瘦(34%)、恶心呕吐(30%)、腹泻(21%)和呕血(15%)等为主,34%病人有胆汁郁滞,血清胆红素>30μmol/L.37例施行上胃肠道钡餐,34例有异常发现;44例施行内镜检查,43例发现绒毛状壶腹肿瘤、肿瘤位于十二指肠第一部3例,第二部39例,第三部4例.遗漏的1例位于第四部.超声扫描检查34例,显示胆管扩张12例.CT扫描检查13例.显示胆管扩张6例,十二指肠壁增厚10例,正常3例.
The incidence of villous tumours of the duodenum increased one by one. Seventy-three cases were summarized in 1981 and 161 cases were summarized in 1989. The authors collected 47 cases of duodenal villi treated by 19 surgical departments in France from 1974 to 1992. Tumors, not including tumors from the ampulla, biliary tract or pancreas side. In the whole group, there were 21 males and 26 females with a mean age of 61.6±12.3 years. The median follow-up period was 46 months (16-314 months). 6 cases of the original gastrointestinal cancer, 4 cases of history of duodenal ulcer, 2 cases of familial colon polyposis, 1 case of Gardner syndrome. Clinical manifestations of abdominal pain (47%), weight loss (34%), nausea Vomiting (30%), diarrhea (21%), and vomiting (15%) were the major causes, 34% of patients had biliary stagnation, serum bilirubin >30 μmol/L, 37 cases of upper gastrointestinal tract barium meal, 34 cases had Abnormal findings; 44 cases underwent endoscopic examination, 43 cases of villi-ampullary tumor, 3 cases of tumor located in the first part of the duodenum, 39 cases of the second part, 4 cases of the third part. 1 case of omission was located in the 4th Department. Ultrasound examination of 34 cases, showed bile duct dilatation in 12 cases. CT scan in 13 cases. Biliary dilatation in 6 cases, duodenal wall thickening in 10 cases, normal in 3 cases.