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38例异位胰腺诊治分析
Diagnosis and treatment of 38 cases of heterotopic pancreas pancreas
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DOI:
作者:
黄湘辉,武鸿彪,丁小云,严志龙,袁旦平
HUANG Xianghui, WU Hongbiao, DING Xiaoyun, YAN Zhilong, YUAN Danping
作者单位:
宁波市第一医院
Ningbo First Hospital
关键词:
异位胰腺;超声内镜;诊治
heterotopic pancreas; EUS; diagnosis and treatment
摘要:
目的 探讨 38例异位胰腺的临床表现、诊断及治疗。方法 回顾性分析宁波市第一医院外科手术或内镜治疗后病理证实的异位胰腺患者38例的临床资料。结果 34例异位胰腺患者有临床表现,4例无特殊不适;36例异位胰腺分布于胃,胃窦(24例),胃体(11例),胃底(1例),有2例发生于十二指肠球部,其他部位未发现异位胰腺。38例患者中有34例接受超声内镜检查,表现为均匀或不均匀低回声(79.4%)、高回声(14.7%)和不均质回声(5.9%),中位直径1.5cm(0.7cm~4cm),其中10例超声内镜提示为异位胰腺(准确率29.4%),11例超声内镜误为间质瘤,2例误为脂肪瘤,2例误为胃息肉,1例误为神经内分泌瘤,1例误为胃囊肿,1例误为胃囊肿伴溃疡,其余6例性质不明。34例行内镜下治疗,4例行外科手术治疗,随访无一例死亡。结论 异位胰腺临床表现缺乏特异性,超声内镜检查是异位胰腺的首选方法,治疗上推荐以内镜下治疗为首选,外科切除次之。
Objective To discuss the symptoms, diagnosis and treatments of 38 cases of heterotopic pancreas. Methods The clinical data of 38 patients with heterotopic pancreas confirmed by pathology after surgery or endoscopic treatment were analyzed retrospectively in Ningbo first hospital. Results 34 cases of heterotopic pancreas had clinical manifestations, 4 cases had no special discomfort.; In 36 cases, the heterotopic pancreas were distributed in the stomach, gastric antrum (24 cases), gastric body (11 cases), gastric fundus (1 case), 2 cases occurred in duodenal bulb, and no heterotopic pancreas was found in other locations. 34 of the 38 patients underwent endoscopic ultrasonography, characterized by uniform or nonuniform hypoechoic (79.4%), hyperechoic (14.7%), and heterogeneous echopattern (5.9%), with a median diameter of 1.5 cm (0.7cm~4.0cm), 10 cases of endoscopic ultrasound showed heterotopic pancreas (diagnostic accuracy of 29.4%), 11 cases were misdiagnosed as gastrointestinal stromal tumor, 2 cases were misdiagnosed as gastrointestinal lipoma, 2 cases were misdiagnosed as gastric polyps, 1 cases were misdiagnosed as neuroendocrine tumor, 1 cases were misdiagnosed as gastric cyst, 1 cases were misdiagnosed as gastric cyst and ulcer, and the remaining 10 cases were unknown in nature. 34 cases were treated with endoscopy and 4 cases were treated by surgery. No case of death was followed up. Conclusion The clinical manifestations of heterotopic pancreas are not specific. EUS is the first choice for heterotopic pancreas. The most recommended treatment is endoscopic treatment, followed by surgical resection.
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