十二指肠旁胰腺炎的临床和形态学特征：意大利120例患者的经验

Clinical and Morphological Features of Paraduodenal Pancreatitis: An Italian Experience With 120 Patients.

作者信息

de Pretis Nicolò, Capuano Fabiana, Amodio Antonio, Pellicciari Mattia, Casetti Luca, Manfredi Riccardo, Zamboni Giuseppe, Capelli Paola, Negrelli Riccardo, Campagnola Pietro, Fuini Arnaldo, Gabbrielli Armando, Bassi Claudio, Frulloni Luca

机构信息

From the Departments of *Medicine, †Surgery, ‡Radiology, and §Pathology, Pancreas Center, University of Verona; and ∥Gastroenterology Unit, Ospedale Maggiore, Verona, Italy.

出版信息

Pancreas. 2017 Apr;46(4):489-495. doi: 10.1097/MPA.0000000000000781.

DOI:10.1097/MPA.0000000000000781

PMID:28196024

Abstract

OBJECTIVES

This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP).

METHODS

A final diagnosis of PP was based on surgical specimens in resected patients and on imaging in nonoperated patients. Clinical, radiological, and pathological data were collected and reevaluated.

RESULTS

We studied 120 patients, 97.5% of whom were drinkers and 97.5% were smokers. Symptoms at clinical onset were acute pancreatitis in 78 patients (65%) and continuous pain in 68 patients (55.8%). Other symptoms were vomiting (36.7%), weight loss (25.8%), and jaundice (11.7%). Cystic variant was diagnosed in 82 patients (68.0%), and solid variant was diagnosed in 38 patients (32.0%). Pure and diffuse forms were observed in 22 (18.3%) and 98 (81.7%) patients, respectively. Pancreatic calcifications were present at clinical onset in 5.0% of the patients and in 61.0% at the end of follow-up. Somatostatin analogs were used in 13 patients (10.8%), and 81 patients (67.0%) underwent surgery.

CONCLUSIONS

The clinical profile of PP was found to be middle-aged men who were heavy drinkers and smokers with painful pancreatitis and was associated with vomiting and weight loss. In nonresponders, alcohol withdrawal and medical therapy can be proposed as a first-line treatment, and surgery as a second-line treatment.

摘要

目的

本研究旨在评估十二指肠旁胰腺炎（PP）的临床和影像学特征以及临床结局。

方法

PP的最终诊断基于手术切除患者的手术标本以及未手术患者的影像学检查结果。收集并重新评估临床、影像学和病理数据。

结果

我们研究了120例患者，其中97.5%为饮酒者，97.5%为吸烟者。临床发病时的症状为78例（65%）急性胰腺炎和68例（55.8%）持续性疼痛。其他症状包括呕吐（36.7%）、体重减轻（25.8%）和黄疸（11.7%）。82例（68.0%）诊断为囊性变型，38例（32.0%）诊断为实性变型。分别在22例（18.3%）和98例（81.7%）患者中观察到单纯型和弥漫型。5.0%的患者在临床发病时出现胰腺钙化，随访结束时为61.0%。13例患者（10.8%）使用了生长抑素类似物，81例患者（67.0%）接受了手术。