Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
HPB (Oxford). 2018 Nov;20(11):1004-1011. doi: 10.1016/j.hpb.2018.04.004. Epub 2018 May 26.
As intrapancreatic accessory spleen (IPAS) is rarely encountered during clinical practice, the aim of this review was to summarize the epidemiologic features, the diagnosis and treatment of IPAS.
MEDLINE and EMBASE were searched for articles reporting on IPAS. Categorical variables were reported as frequency and percentage. Continuous variables were reported as median (range).
A total of 105 patients were included, of which 73% were detected incidentally. The male/female ratio was 1.23. The size of IPAS in patients who had previously undergone splenectomy was larger than that of patients without prior splenectomy (2.5 cm vs 1.5 cm; p = 0.020). No preoperative examination was able to make a definite diagnosis for all IPASs. More than half of the patients (55%) received surgical treatment, most of which (87%) were suspected as pancreatic neuroendocrine tumors (p-net) preoperatively.
Although rare, IPAS should be considered in the differential of patients with suspected incidental p-net, especially if there has been a past history of splenectomy. Preoperative diagnosis is important as unnecessary surgery can be avoided. As it is difficult to make a definite diagnosis of IPAS by one single examination, multiple techniques may be required.
由于胰腺内副脾(intrapancreatic accessory spleen,IPAS)在临床实践中很少见,因此本综述的目的是总结 IPAS 的流行病学特征、诊断和治疗方法。
检索 MEDLINE 和 EMBASE 中关于 IPAS 的文献。分类变量以频率和百分比报告。连续变量以中位数(范围)报告。
共纳入 105 例患者,其中 73%为偶然发现。男女比例为 1.23。既往行脾切除术患者的 IPAS 大小大于未行脾切除术患者(2.5cm 比 1.5cm;p=0.020)。所有 IPAS 术前均无明确检查能做出明确诊断。超过一半的患者(55%)接受了手术治疗,其中大多数(87%)术前疑似胰腺神经内分泌肿瘤(p-net)。
虽然罕见,但对于疑似偶发性 p-net 的患者,应考虑 IPAS 的鉴别诊断,尤其是有脾切除史的患者。术前诊断很重要,可避免不必要的手术。由于单一检查很难明确诊断 IPAS,可能需要多种技术。