Tibayan F, Vierra M, Mindelzun B, Tsang D, McClenathan J, Young H, Trueblood H W
Department of Surgery, Stanford University Medical School, Stanford, California 94305-5101, USA.
Am J Surg. 2000 May;179(5):349-51. doi: 10.1016/s0002-9610(00)00376-7.
Pancreatitis and jaundice secondary to ductal obstruction are common in intraductal papillary mucinous tumors (IPMT) of the pancreas. However, the incidence and severity of the complications of obstruction are not well documented. The aim of the study was to investigate the clinical presentation and outcome of 10 patients with IPMT.
All cases of IPMT diagnosed between 1994 and 1999 were reviewed.
Four of the 10 patients developed severe acute illness with systemic complications resulting from ductal obstruction. Three suffered acute cholangitis with sepsis, and 1 developed necrotizing pancreatitis and ARDS. There was 1 postoperative death in a patient with adenocarcinoma. All other patients are alive and well with a median follow-up of 26 months (survival 90%).
Pancreatic or common bile duct obstruction in IPMT may result in acute, life-threatening disease. Aggressive surgical therapy is warranted before development of complications of ductal obstruction or progression of tumor occurs.
胰腺导管内乳头状黏液性肿瘤（IPMT）继发胰腺炎和导管阻塞引起的黄疸较为常见。然而，阻塞并发症的发生率和严重程度尚无充分记录。本研究旨在调查10例IPMT患者的临床表现及预后。
回顾了1994年至1999年间诊断的所有IPMT病例。
10例患者中有4例因导管阻塞出现严重急性疾病并伴有全身并发症。3例发生急性胆管炎并伴有败血症，1例发生坏死性胰腺炎和急性呼吸窘迫综合征（ARDS）。1例腺癌患者术后死亡。所有其他患者均存活良好，中位随访时间为26个月（生存率90%）。
IPMT中的胰腺或胆总管阻塞可能导致急性、危及生命的疾病。在导管阻塞并发症发生或肿瘤进展之前，积极的手术治疗是必要的。
