异位胰腺的诊断与治疗：附35例病例报告.pdfVIP

中华肝胆外科杂志2007年12月第13卷第12期 Chin J Hepatobiliary Surg，December 2007，Vo1．13，No．12 · 825 · · 论著 · 异位胰腺的诊断与治疗：附35例病例报告 徐东升 孙备 张羽 孟庆辉 刘杰 吴祥松 武林枫 姜洪池 【摘要】 目的 探讨异位胰腺的临床特点、诊断方法及外科处理原则。方法 对我院自1996年 7月至2006年8月经病理确诊的35例异位胰腺病人的临床特点、影像资料及治疗方法进行回顾性 分析。结果 本组35例病人中男16例，女 19例，年龄18个月至 74岁，平均43．5岁。单发33例， 多发2例。异位胰腺分布部位：胃13例，十二指肠5例，空肠 6例，结肠 6例，胆囊、胆总管、后腹膜各 1例，回、升结肠并发2例。术前仅 6例确诊，8例误诊，21例漏诊。全组均经病理证实，4例内镜下高 频电灼或电凝切除，31例手术治疗。随访2．4～8年，无一例出现术后并发症。结论 异位胰腺的临 床表现无特异性，易漏诊和误诊，内镜超声的临床应用能显著地提高诊断率。异位胰腺一旦出现症 状，需早期内镜电凝或电切和手术治疗，以明确诊断及避免出现严重的并发症。无症状者无需治疗但 应加强随访。 【关键词】 胰腺疾病； 异位胰腺； 诊断； 治疗 Diagnosis and treatment of heterotopic pancreas：an analysis of 35 cases XU Dong—sheng ．SUN Bei． ZHANG Yu，et a1． Department of Hepatobiliary Pancreatic Surgery，the First Affiliated Hospital，Harbin Medical University，Harbin 1 50001，P．R．China [：Abstract] Objective To investigate the clinical features，diagnostic methods and surgical man— agement principles of heterotopic pancreas．Methods The clinical data of 35 patients with pathologi— cally proven heterotopic pancreas treated in our hospital from July 1996 t6 August 2006 were retro— spectively analyzed．Results Of the 35 patients with an age ranging from 18 months to 74 years (mean=43．5 years)，1 6 were male and 19 female．Solitary heterotopic pancreas was found in 33 pa tients and multiple ones in 2．Its distributing sites were stomach in 1 3 patients，duodenum in 5，jej u— num in 6，colon in 6，gallbladder in 1，common bile duct in 1 and posterior peritoneum in 1．Ileum and colon coincidence was seen in 2．Only 6 cases were correctly diagnosed before operation．Eight cases were misdiagnosed and 21 were not diagnosed at al1．Four cases were treated with endoscopic high fre— quency fulgurate or electric coagulation cut and 31 with operation．The follow—up for 2．4～8 years showed that there was no recurrence．Conclusion Heterotopic pancreas is difficult t