Pyke C M, van Heerden J A, Colby T V, Sarr M G, Weaver A L
Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Ann Surg. 1992 Feb;215(2):132-9. doi: 10.1097/00000658-199202000-00007.
Serous cystadenoma of the pancreas is a rare lesion thought to be almost invariably benign. Since 1978, 211 cases have been reported in the literature. Some have been recognized by computed tomography (CT) when small and asymptomatic. The authors have reviewed their experience with 40 patients (median follow-up of 1.9 years, maximum of 22.2 years) from 1936 to 1991. One third (13) were asymptomatic, of whom eight (20%) were discovered intraoperatively. Of those 20 who had CT, an unequivocal preoperative diagnosis was reached in none. Needle biopsy proved accurate in two patients. Endoscopic retrograde cholangiopancreatography (ERCP) and biopsy were performed with diagnostic success on one occasion. Three patients presented acutely. The tumor was resected in 90%, with an operative mortality rate of 10%. Enucleation of the tumor without formal anatomic pancreatectomy necessitated reoperation for complications in four of eight patients. Survival after successful resection paralleled expected survival. Serous cystadenoma may be associated with von Hippel-Lindau syndrome. The current role for conservative management remains questionable because of our current inability to reliably differentiate many of these benign neoplasms from malignant cystic neoplasms of the pancreas.
胰腺浆液性囊腺瘤是一种罕见病变，几乎均被认为是良性的。自1978年以来，文献中已报道211例。有些病例在较小且无症状时通过计算机断层扫描（CT）得以识别。作者回顾了他们在1936年至1991年间对40例患者（中位随访时间为1.9年，最长为22.2年）的治疗经验。三分之一（13例）无症状，其中8例（20%）在手术中被发现。在接受CT检查的20例患者中，术前均未做出明确诊断。针吸活检在2例患者中被证明是准确的。内镜逆行胰胆管造影（ERCP）及活检有1次取得诊断成功。3例患者急性发病。90%的患者接受了肿瘤切除，手术死亡率为10%。8例患者中有4例在未进行正规解剖性胰腺切除而仅行肿瘤剜除术后因并发症而需再次手术。成功切除后的生存率与预期生存率相当。浆液性囊腺瘤可能与冯·希佩尔-林道综合征有关。由于目前我们无法可靠地区分许多这类良性肿瘤与胰腺恶性囊性肿瘤，保守治疗的当前作用仍存在疑问。
