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目的对胰腺浆液性囊腺瘤的诊断与治疗相关问题进行分析。方法对中国医科大学附属第一医院普通外科2006年4月至2012年4月收治的20例胰腺浆液性囊腺瘤病人的临床资料进行回顾性分析。结果 20例病人中,男6例,女14例。肿瘤位于胰头部5例,胰体及胰体尾部15例。瘤体平均直径5.7 cm。临床表现为上腹隐痛不适15例,其中腹痛伴腹胀8例,包括轻度恶心2例、黄疸1例。超声和CT检查均发现病灶并准确定位。20例均行手术治疗。1例行保留十二指肠的胰头切除术,4例行胰十二指肠切除术,2例行胰腺中段切除术,7例行胰体尾脾切除术,6例行保留脾脏的胰体尾切除术。5例术后发生胰瘘及腹腔感染,经非手术治疗均治愈。无围手术期死亡病例,随访时间12～79个月,中位随访39.5个月,均无肿瘤复发。结论超声、CT是胰腺浆液性囊腺瘤主要的影像学检查方法,可早期准确的发现及定位病灶。难以定性的胰腺囊性肿瘤应行手术治疗,手术应按良性肿瘤手术原则,尽量保留器官,减少手术创伤。胰腺浆液性囊腺瘤预后良好。
Objective To analyze the diagnosis and treatment of pancreatic serous cystadenoma. Methods The clinical data of 20 patients with pancreatic serous cystadenoma admitted to the General Surgery Department of First Affiliated Hospital of China Medical University from April 2006 to April 2012 were retrospectively analyzed. Results 20 patients, 6 males and 14 females. Tumor located in the head of the pancreas in 5 cases, pancreatic body and pancreatic body tail in 15 cases. The average diameter of tumor 5.7 cm. Clinical manifestations of abdominal pain and discomfort in 15 cases, including abdominal pain with abdominal distension in 8 cases, including 2 cases of mild nausea, jaundice in 1 case. Ultrasound and CT examination found lesions and accurate positioning. Twenty patients underwent surgical treatment. A routine pancreaticoduodenectomy with routine duodenal preservation was performed in 4 cases, pancreatoduodenectomy in 4 cases, middle resection of pancreas in 2 cases, resection of pancreas in the pancreas and tail in 7 cases, pancreas in 6 cases Tail resection. 5 cases of pancreatic fistula and abdominal infection occurred, were cured by non-surgical treatment. No cases of perioperative deaths, follow-up time of 12 to 79 months, the median follow-up of 39.5 months, no tumor recurrence. Conclusion Ultrasound, CT is the main imaging diagnosis of pancreatic serous cystadenoma, early and accurate detection and localization of lesions. Difficult to be qualitative pancreatic cyst tumors should be treated surgically, surgery should be based on the principle of benign tumor surgery, try to retain the organs and reduce surgical trauma. Pancreatic serous cystadenoma prognosis is good.