Afridi Shabbir A, Kazaryan Airazat M, Marangos Irina Pavlik, Røsok Bård I, Fretland Åsmund A, Yaqub Sheraz, Edwin Bjørn
Intervention Centre, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Intervention Centre, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway; Department of Surgery, Skien Hospital, Sykehuset Telemark Health Trust, Skien, Norway.
JSLS. 2014 Apr-Jun;18(2):236-42. doi: 10.4293/108680813X13753907291837.
Solid pseudopapillary tumors of the pancreas are rare and occur most frequently in young women. They have an uncertain pathogenesis and unclear clinical behavior. Our aim was to evaluate the clinical presentation of solid pseudopapillary tumors and assess the efficacy of treatment with minimally invasive surgery.
From March 1997 to February 2011, 13 of 273 patients who underwent laparoscopic procedures on the pancreas were found to have solid pseudopapillary tumors. There were 12 female patients and 1 male patient. The median age was 21 years (range, 15-77 years). Abdominal pain was the most common presenting symptom (n=9). Tumors were incidentally found in 3 patients on computed tomography scans obtained for other reasons.
Enucleation of the tumor was performed in 4 patients, including 3 in whom the tumor was located in the head of the pancreas. Eight patients underwent distal pancreatectomy with splenectomy, whereas spleen-preserving distal pancreatectomy was performed in one case. The median tumor size was 6 cm (range, 1.5-11 cm), the median operative time was 197 minutes (range, 68-320 minutes), and the median blood loss was 50 mL (range, <50-750 mL). Distal resections were performed with a linear stapler. Four patients had postoperative complications. The median length of hospital stay was 5 days (range, 2-12 days). During a median follow-up period of 11 months (range, 3-121 months), no local recurrences or distant metastases were found.
Laparoscopic resections and enucleations of solid pseudopapillary tumors of the pancreas can be performed safely and with adequate resection margins even if the tumors are located in the head of the organ.
胰腺实性假乳头状瘤罕见，多见于年轻女性。其发病机制尚不明确，临床行为也不清楚。我们的目的是评估胰腺实性假乳头状瘤的临床表现，并评估微创手术治疗的疗效。
1997年3月至2011年2月，在273例行胰腺腹腔镜手术的患者中，有13例被发现患有胰腺实性假乳头状瘤。其中女性患者12例，男性患者1例。中位年龄为21岁（范围15 - 77岁）。腹痛是最常见的症状（9例）。3例患者因其他原因行计算机断层扫描时偶然发现肿瘤。
4例患者行肿瘤剜除术，其中3例肿瘤位于胰头。8例行胰体尾切除术加脾切除术，1例行保留脾脏的胰体尾切除术。肿瘤中位大小为6 cm（范围1.5 - 11 cm），中位手术时间为197分钟（范围68 - 320分钟），中位失血量为50 mL（范围<50 - 750 mL）。胰体尾切除用直线切割吻合器。4例患者有术后并发症。中位住院时间为5天（范围2 - 12天）。中位随访期为11个月（范围3 - 121个月），未发现局部复发或远处转移。
即使肿瘤位于胰头，胰腺实性假乳头状瘤的腹腔镜切除和剜除术也可安全进行，且切除边缘足够。
