Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, ML 0558, SRU Room 1466, Cincinnati, OH, 45219, USA.
J Gastrointest Surg. 2017 Dec;21(12):2110-2118. doi: 10.1007/s11605-017-3534-7. Epub 2017 Aug 14.
Chronic pancreatitis and incidentally discovered pancreatic lesions present significant diagnostic and therapeutic challenges for surgeons. While both decompressive and resection procedures have been described for treatment of chronic pancreatitis, optimal management must be tailored to each patient's individual disease characteristics, parenchymal morphology, and ductal anatomy. Surgeons should strive to achieve long-lasting pain relief while preserving native pancreatic function. For patients with incidentally discovered pancreatic lesions, differentiating benign, pre-malignant, and malignant lesions is critical as earlier treatment is thought to result in improved survival. The purpose of this evidence-based manuscript is to review the presentation, workup, surgical management, and associated outcomes for patients with chronic pancreatitis or incidentally discovered solid and cystic lesions of the pancreas.
慢性胰腺炎和偶然发现的胰腺病变对外科医生来说是具有挑战性的诊断和治疗难题。虽然减压和切除术都被用于治疗慢性胰腺炎,但最佳的治疗方案必须根据每个患者的个体疾病特征、实质形态和导管解剖结构进行调整。外科医生应该努力实现持久的疼痛缓解,同时保留胰腺的固有功能。对于偶然发现的胰腺病变患者,区分良性、癌前病变和恶性病变至关重要,因为早期治疗被认为可以提高生存率。本循证文献的目的是回顾慢性胰腺炎或偶然发现的胰腺实性和囊性病变患者的临床表现、检查、手术治疗及相关结果。