ABSTRACT
Objective To study the diagnosis,treatment and prognosis of patients with solid-pseudopapillary tumor of the pancreas (SPTP).Methods The clinical and follow-up data of 68 patients with SPTP treated in the Affiliated Tumor Hospital of Zhengzhou University from January 2008 to March 2017 were retrospectively analyzed.Results There were 6 males and 62 females,with an average age +/-S.D.of (32.0 ± 12.0) years.The mean tumor size was (4.4 ±2.3) cm.The primary symptom was abdominal pain,and a pancreatic mass was subsequently detected.All the patients underwent surgical resection which included pancreaticoduodenectomy,duodenal preserving pancreatic head resection,distal pancreatectomy,middle pancreatectomy,local excision,resection of pancreatic tail plus splenectomy and distal pancreaticosplenectomy.Postoperative histopathological examination confirmed solid pseudopapillary tumor of the pancreas in all these patients.Twenty-one patients (30.9％) developed postoperative complications,which included pancreatic fistula in 12 patients (17.7％),hemorrhage in 2 patients (2.9％),pleural effusion in 2 patients (2.9％),incision infection in 3 patients (4.4％),and gastric emptying disorder in 2 patients (2.9％).There was no in-hospital mortality.The average length of hospital stay was (26.0 ± 10.0) days.Of the 57 patients (83.8％) who were followed-up (mean 38 months,range 3 to 114 months),11 patients developed postoperative indigestion and 2 patients diabetes.No patient developed tumor recurrence,metastasis and death.Conclusions SPTP is a low grade malignant tumor,which is found primarily in young women.The clinical characteristics are non-specific,and preoperative diagnosis is difficult.Excellent prognosis can be achieved with surgical resection which is the preferred treatment for SPTP.
ABSTRACT
Objective To compare and discuss the clinical application effect of the end-to-end anastomosis of pancreatic and intestinal anastomosis,binding type of pancreatic and intestinal anastomosis,end-to side pancreatic duct anastomosis and modified pancreatic duct jejunum anastomosis.Methods Collected pancreatoduodenectomy in 95 cases,the end-to-end pancreatico duodenal sleeve type anastomosis in 23 cases,binding type pancreatic enteric anastomosis in 18 cases,end to side pancreaticojejunostomy anastomosis in 28 cases,improvement of the pancreatic duct jejunum end to side anastomosis in 26 cases,compared with four groups of patients with pancreatic enteric anastomosis time and postoperative complications.Results Anastomosis time:A group (34.0 ± 4.6) min,B group (31.0±5.8) min,C group (32.0 ±6.3) min,D group (14.0 ±4.2) min(P=0.037,P＜0.05).And the incidence rate of postoperative pancreatic fistula,bile leakage,abdominal cavity or digestive tract bleeding had no significant difference (P ＞ 0.05).Improvement of the pancreatic tube jejunum end to side coincident with a low incidence of pancreatic fistula,but different pancreatic enteric anastomosis way pancreatic fistula rate difference was not statistically significant,improvement of the pancreatic duct and jejunum mucosa end side group pancreatic enteric anastomosis anastomosis time significantly shorter in the three groups,the difference was statistically significant (P ＜ 0.05).Conclusion Improvement of pancreatic duct jejunum end to side anastomosis with short operation time,low incidence of pancreatic fistula,and the operation is simple and practical,safe.