【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。更多还原

【Abstract】 Objective To investigate the clinical features,diagnostic methods and surgical man- agement principles of heterotopie pancreas.Methods The clinical data of 35 patients with pathologi- cally proven heterotopic pancreas treated in our hospital from July 1996 to 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),16 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 13 patients,duodenum in 5,jeju- 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 all.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 to be correctly di- agnosed before operation due to lacking of specific characteristics and examination methods.The endo- scopic ultrasonography can significantly improve the diagnostic rate.Early electric coagulation or cut by endoscopic high frequency fulgurate or operations should be performed once the patients have clini- cal symptoms to identify diagnosis and avoid severe complications.Asymptomatic eases need not be managed but follow-up should be strengthened.更多还原