Surgical treatment for chronic pancreatitis characterized by a pancreatic mass
10.3760/cma.j.issn.1007-631X.2010.08.015
- VernacularTitle:以胰腺肿块为特征的慢性胰腺炎的外科治疗
- Author:
Jun SHI
;
Feng XIA
;
Guanqun LI
;
Qingyu ZHANG
- Publication Type:Journal Article
- Keywords:
Pancreatitis,chronic;
Diagnosis;
Surgical procedures,operative
- From:
Chinese Journal of General Surgery
2010;25(8):649-651
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the diagnostic and therapeutic experience on chronic pancreatitis characterized by a pancreatic mass. Methods The clinical data of 28 cases of chronic pancreatitis with mass undergoing surgical operations were retrospectively analyzed in our hospital from June1999 to June 2009. Results Among the 28 cases, 19 were diagnosed as carcinoma, 9 cases were diagnosed as chronic pancreatitis respectively before operation. Needle aspiration biopsy and/or postoperative pathology identified chronic pancreatitis in all cases. The symptom included abdominal pain (22 cases),jaundice (15 cases), and obstruction of duodenum (4 cases). Pancreaticoduodenectomy was performed in 17 cases, choledochojejunostomy performed in 3 cases, pancreatojejunostomy performed in 1 case.Duodenum-preserving resection was performed in 4 cases, and resection of body and tail of the pancreas were performed in 3 cases. There was no operative death. Postoperative complications included pancreatic leakage (2 cases), severe gastroplegia (2 cases) and stress peptic ulcer with massive bleeding ( 1 case). All patients got follow-up ranging from 6 months to 5 years. Recurrence of abdominal pain developed in 7 cases after 2 years. Canceration of pancreatic mass was found respectively in 8 months, 1 year after operation in one each cases. Conclusion Preoperative differential diagnosis of chronic pancreas and pancreatic tumor was difficult. Although needle aspiration biopsy is the effective method for diagnosis, there may be still a possibility of missed diagnosis/misdiagnosis.