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胰腺实性假乳头状瘤58例手术治疗及预后分析

Surgical management and outcome of solid-pseudopapillary tumor of pancreas: a series of 58 cases

摘要:

目的 探讨胰腺实性假乳头状瘤手术治疗及预后特点.方法 回顾分析2001年1月至2010年12月58例胰腺实性假乳头状瘤病例的临床资料.其中男性7例,女性51例;年龄9~70岁,平均30岁.多数患者有腹痛症状.手术治疗包括胰十二指肠切除术21例,远端胰切除术30例,中段胰切除术6例,肿瘤局部剜除术1例,保留十二指肠胰头切除术1例.结果 住院时间12~64 d,平均23.8 d.术后出现并发症13例(22.4%),其中8例A级胰漏,1例消化道出血,2例胸腔积液,2例切口液化、感染.分别因消化道出血及切口严重感染再次手术2例;无住院期间死亡.44例获得随访,随访7~136个月,平均41个月;其中8例发生术后消化不良,4例发生糖尿病,无术后复发、转移及死亡.结论 胰腺假乳头状瘤为潜在低度恶性肿瘤,好发于年轻女性,手术治疗效果较好.

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abstracts:

Objective To study the surgical management of solid-pseudopapillary tumor of the pancreas (SPTP) and its characteristics of outcome.Methods Fifty-eight patients with SPTP of the pancreas admitted from January 2001 to December 2010 were retrospectively analyzed.There were 7 male and 51 female patients,with an average age of 30 years (rangeing 9 to 70 years).Most patients were symptomatic before admission; the most common symptom was abdominal pain.Of the 58 patients,21 patients underwent pancreaticoduodenectomy,30 patients underwent distal pancreatectomy,6 patients underwent central pancreatectomy,1 patient underwent simple tumor enucleation,and 1 patients underwent duodenum-preserving pancreatic head resection.Results The average length of stay in hospital was 23.8 days (ranging 12 to 64 days).Thirteen patients (22.4%) developed postoperative complications,including grade A postoperative pancreatic fistula of 8 cases,gastrointestinal tract bleeding of 1 case,pleural effusion of 2 cases,wound infection and fat liquefaction of 2 cases.Two patients underwent reoperation due to gastrointestinal tract bleeding or wound infection.There was no hospital death.Forty-four patients were followed-up for 7 to 136 months with an average of 41 months.All the 44 patients were alive,while 8 patients developed dyspepsia and 4 patients developed diabetes mellitus.There were no tumor recurrences or metastasis.Conclusions SPTP is found primarily in young women.Excellent prognosis would be achieved with surgical resection.

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