经内镜胰管支架置入联合肿瘤剜除术治疗胰腺颈部良性肿瘤1例报告
|
摘要
<正>随着影像诊断技术的不断发展,胰腺良性肿瘤不断被鉴别诊断,其中绝大多数需要及时的外科手术干预。因肿瘤部位不同,其手术术式选择各异。包括胰腺肿瘤剜除、胰腺中段切除、远端胰腺切除、胰十二指肠切除等[1]。其中,肿瘤剜除术主要适用于凸出于胰腺实质表面,且与主胰管间有一定安全距离的良性肿瘤,如胰岛素瘤[2]。当肿瘤位置较深或紧贴主胰管时,若单纯行肿瘤剜除术,极易损伤主胰管,造成术后胰漏。本团队针对1例胰腺颈部良性肿瘤患者,采用经内镜胰管支架置入联合胰腺肿瘤剜除术的治疗方式,在预防术后胰漏方面获得了
引文
[1]LU M,YUAN CH,XIU DR.Laparoscopic local resection of pancreatic tumors:Selection of indications and perioperative management[J].J Laparo Surg,2016,21(12):884-886.(in Chinese)鲁蒙,原春辉,修典荣.腹腔镜胰腺肿瘤局部切除术:适应证选择及围手术期管理[J].腹腔镜外科杂志,2016,21(12):884-886.
[2]WU JL,GUO F,WEI JS,et al.Surgical treatment for pancreatic neuroendocrine neoplasmas[J].J Zhejiang Univ:Medical Sciences,2016,45(1):31-35.(in Chinese)吴峻立,郭峰,卫积书,等.胰腺神经内分泌肿瘤的外科治疗[J].浙江大学学报:医学版,2016,45(1):31-35.
[3]ZHAO DF,ZHANG T.Middle segment pancreatectomy in treatment for benign pancreatic tumors and its effect on pancreatic exocrine function[J].Chin J Endocr Surg,2016,10(3):189-191,211.(in Chinese)赵德芳,张彤.中段胰腺切除术治疗胰颈体良性肿瘤对胰腺外分泌功能的影响[J].中华内分泌外科杂志,2016,10(3):189-191,211.
[4]FAITOT F,GAUJOUX S,BARBIER L,et al.Reappraisal of pancreatic enucleations:A single-center experience of 126procedures[J].Surgery,2015,158(1):201-210.
[5]XU JW,ZHAN HX,HU SY,et al.Minimally invasive organpreserving pancreatic surgery:Current status and advances[J].J Laparo Surg,2017,22(8):623-626.(in Chinese)徐建威,展翰翔,胡三元,等.保留器官的微创胰腺手术:现状及进展[J].腹腔镜外科杂志,2017,22(8):623-626.
[6]LU WJ,CAI HL,YE MD,et al.Enucleation of non-invasive tumors in the proximal pancreas:Indications and outcomes compared with standard resections[J].J Zhejiang Univ Sci B,2017,18(10):906-916.
[7]ZHANG T,XU J,WANG T,et al.Enucleation of pancreatic lesions:indications,outcomes,and risk factors for clinical pancreatic fistula[J].J Gastrointest Surg,2013,17(12):2099-2104.
[8]JILESEN AP,van EIJCK CH,BUSCH OR,et al.Postoperative outcomes of enucleation and standard resections in patients with a pancreatic neuroendocrine tumor[J].World J Surg,2016,40(3):715-728.
[9]XU TZ,WU JC.Effect of preoperative pancreatic stent in preventing pancreatic leakage after distal pancreatectomy[J].JHepatobiliary Surg,2007,15(1):57-58.(in Chinese)徐铁峥,武金才.术前胰管内支架预防胰腺远端切除术后胰漏[J].肝胆外科杂志,2007,15(1):57-58.
[10]BASSI C,MARCHEGIANI G,DERVENIS C,et al.The 2016update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after[J].Surgery,2017,161(3):584-591.
[11]HUANG Q,ZHU CL.The clinical application of function-preserving pancreatic surgery in treating pancreatic neuroendocrine tumors[J].Chin J Pancreatol,2017,17(2):119-121.(in Chinese)黄强,朱成林.功能保留性胰腺手术在胰腺神经内分泌肿瘤外科治疗中的应用[J].中华胰腺病杂志,2017,17(2):119-121.
[12]REN CY,BAI T,CUI W,et al.Safety and feasibility of enhanced recovery after surgery in perioperative management of pancreatectomy:A Meta analysis[J].Chin J Dig Surg,2018,17(7):729-739.(in Chinese)任超逸,白同,崔巍,等.加速康复外科应用于胰腺切除围术期安全性和可行性的Meta分析[J].中华消化外科杂志,2018,17(7):729-739.
[13]WANG XP,PAN YL,GUO XG.Advances in endoscopic retrograde cholangiopancreatography[J].J Clin Hepatol,2018,34(3):473-481.(in Chinese)王向平,潘阳林,郭学刚.经内镜逆行胰胆管造影术的若干进展[J].临床肝胆病杂志,2018,34(3):473-481.
[2]WU JL,GUO F,WEI JS,et al.Surgical treatment for pancreatic neuroendocrine neoplasmas[J].J Zhejiang Univ:Medical Sciences,2016,45(1):31-35.(in Chinese)吴峻立,郭峰,卫积书,等.胰腺神经内分泌肿瘤的外科治疗[J].浙江大学学报:医学版,2016,45(1):31-35.
[3]ZHAO DF,ZHANG T.Middle segment pancreatectomy in treatment for benign pancreatic tumors and its effect on pancreatic exocrine function[J].Chin J Endocr Surg,2016,10(3):189-191,211.(in Chinese)赵德芳,张彤.中段胰腺切除术治疗胰颈体良性肿瘤对胰腺外分泌功能的影响[J].中华内分泌外科杂志,2016,10(3):189-191,211.
[4]FAITOT F,GAUJOUX S,BARBIER L,et al.Reappraisal of pancreatic enucleations:A single-center experience of 126procedures[J].Surgery,2015,158(1):201-210.
[5]XU JW,ZHAN HX,HU SY,et al.Minimally invasive organpreserving pancreatic surgery:Current status and advances[J].J Laparo Surg,2017,22(8):623-626.(in Chinese)徐建威,展翰翔,胡三元,等.保留器官的微创胰腺手术:现状及进展[J].腹腔镜外科杂志,2017,22(8):623-626.
[6]LU WJ,CAI HL,YE MD,et al.Enucleation of non-invasive tumors in the proximal pancreas:Indications and outcomes compared with standard resections[J].J Zhejiang Univ Sci B,2017,18(10):906-916.
[7]ZHANG T,XU J,WANG T,et al.Enucleation of pancreatic lesions:indications,outcomes,and risk factors for clinical pancreatic fistula[J].J Gastrointest Surg,2013,17(12):2099-2104.
[8]JILESEN AP,van EIJCK CH,BUSCH OR,et al.Postoperative outcomes of enucleation and standard resections in patients with a pancreatic neuroendocrine tumor[J].World J Surg,2016,40(3):715-728.
[9]XU TZ,WU JC.Effect of preoperative pancreatic stent in preventing pancreatic leakage after distal pancreatectomy[J].JHepatobiliary Surg,2007,15(1):57-58.(in Chinese)徐铁峥,武金才.术前胰管内支架预防胰腺远端切除术后胰漏[J].肝胆外科杂志,2007,15(1):57-58.
[10]BASSI C,MARCHEGIANI G,DERVENIS C,et al.The 2016update of the International Study Group(ISGPS)definition and grading of postoperative pancreatic fistula:11 years after[J].Surgery,2017,161(3):584-591.
[11]HUANG Q,ZHU CL.The clinical application of function-preserving pancreatic surgery in treating pancreatic neuroendocrine tumors[J].Chin J Pancreatol,2017,17(2):119-121.(in Chinese)黄强,朱成林.功能保留性胰腺手术在胰腺神经内分泌肿瘤外科治疗中的应用[J].中华胰腺病杂志,2017,17(2):119-121.
[12]REN CY,BAI T,CUI W,et al.Safety and feasibility of enhanced recovery after surgery in perioperative management of pancreatectomy:A Meta analysis[J].Chin J Dig Surg,2018,17(7):729-739.(in Chinese)任超逸,白同,崔巍,等.加速康复外科应用于胰腺切除围术期安全性和可行性的Meta分析[J].中华消化外科杂志,2018,17(7):729-739.
[13]WANG XP,PAN YL,GUO XG.Advances in endoscopic retrograde cholangiopancreatography[J].J Clin Hepatol,2018,34(3):473-481.(in Chinese)王向平,潘阳林,郭学刚.经内镜逆行胰胆管造影术的若干进展[J].临床肝胆病杂志,2018,34(3):473-481.