Le Borgne Joël
Clinique chirurgicale II Hôtel-Dieu 44093 Nantes.
Rev Prat. 2002 Sep 15;52(14):1540-5.
The management of cystic and intraductal pancreatic tumours has changed over the last ten years due to increasing fortuitous discovery of incidental cystic lesions of the pancreas and better knowledge of these lesions. CT-scan or MRI can usually differentiate the two most frequent cystic tumours: benign serous cystadenoma and potentially malignant mucinous cystadenoma. Conservative management is wholly justified for serous cystadenoma without complications, whereas mucinous cystadenoma can be cured by pancreatic resection. In case of doubt, endoscopic ultrasonography and study of cystic fluid may be helpful. Recently identified intraductal papillary mucinous neoplasms of the pancreas are premalignant or malignant tumours of the pancreatic ducts clearly visualized by magnetic resonance pancreatography. Curative pancreatic resection should be performed before the invasive adenocarcinoma stage.
在过去十年中，由于胰腺偶然发现的囊性病变越来越多，且对这些病变有了更深入的了解，囊性和导管内胰腺肿瘤的管理发生了变化。CT扫描或MRI通常可以区分两种最常见的囊性肿瘤：良性浆液性囊腺瘤和潜在恶性的黏液性囊腺瘤。对于无并发症的浆液性囊腺瘤，保守治疗是完全合理的，而黏液性囊腺瘤可通过胰腺切除术治愈。如有疑问，内镜超声检查和囊液研究可能会有所帮助。最近发现的胰腺导管内乳头状黏液性肿瘤是胰腺导管的癌前或恶性肿瘤，磁共振胰胆管造影可清晰显示。应在浸润性腺癌阶段之前进行根治性胰腺切除术。
