Chinese Journal of Digestive Surgery 2008;7(6):409-412
Diagnosis and treatment of solid-pseudopapillary tumor of pancreas
Yupei ZHAO ; Bo PAN ; Taiping ZHANG ; Ya HU ; Quan LIAO
Keywords
Pancreatic neoplasms; Solid-pseudopapillary tumor of pancreas; Diagnosis; Treatment
Country
China
Language
Chinese
Abstract
Objective To summarize the clinical experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas(SPTP),and to work out the diagnosis and treatment process which matches the conditions of China.Methods The clinical data of consecutive 50 patients with SPTP who had been admitted to our hospital from January 2001 to March 2007 were retrospectively analyzed.Of all patients,3 were male and 47 female.Their median age Was 24 years(13-60 years).Preoperative imaging examination revealed typical findings and tumor markers were negative.SPIP of 23 cases were located in the head of pancreas,3 in the neck of pancreas,2 in the uncinate process of pancreas.3 in the body of pancreas,18 in the tail of pancreas,and the location of SPTP of 1 case was uncertain.Forty-eight patients underwent the operation of SPTP resection,1 of exploratory laparotomy and 1 of CT-guided fine-needle aspiration biopsy of metastatic lesions.Results Forty-nine out of 50 patients were diagnosed"pancreatic mass"preoperatively.Eighteen of the 32 patients with intact tumor capsule and 11 of the 16 patients without intact tumor capsule underwent operation without pathological examination.Thirty-two patients were followed up for 3-55 months,and no metastasis or invasion of the SPTP was observed.Conclusions Yong females are in the high risk group of SPTP.CT is the most valuable preoperative imaging test.Complete surgical resection is the first choice treatment with good prognosis.Resection of the head of pancreas with the preservation of duodenum and resection of body and tail of pancreas+splenectomy are the commou modalities used for the treatment of SPTP.The intactness of the tumor capsule is an important factor in making surgical plan and deciding the necessity of intraoperative frozen section pathological examination.The most common postoperative complication of SPTP resection is pancreatic fistula.
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