Roder J D, Rösch T, Bautz W, Gerhardt P, Siewert J R
Chirurgische Klinik und Poliklinik, Technischen Universität München.
Chirurg. 1994 Apr;65(4):225-31.
Symptomatic pancreas tumors are diagnosed in general by ERCP, transabdominal ultrasonography, and computed tomography. Endoscopic ultrasonography, angiography (facultative) and video laparoscopy in combination with laparoscopic sonography and peritoneal lavage are providing preoperatively important additional information about the spreading of the tumor. Preoperative diagnostic procedures should allow the surgeon to exclude patients with an unresectable tumor from extended resection. In most of these patients satisfactory palliation can be achieved endoscopically. The indication for surgical treatment of resectable pancreatic tumors is based on the mortality of pancreaticoduodenectomy far beyond 5% in experienced centers. Improved surgical techniques and improved perioperative management together with the implementation of accurate preoperative analysis of risk factors allow resection of primary pancreatic tumors with a low morbidity and mortality.
有症状的胰腺肿瘤一般通过内镜逆行胰胆管造影（ERCP）、经腹超声检查和计算机断层扫描来诊断。内镜超声检查、血管造影（可选）以及结合腹腔镜超声检查和腹腔灌洗的视频腹腔镜检查，可为术前提供有关肿瘤扩散的重要补充信息。术前诊断程序应使外科医生能够排除无法切除肿瘤的患者，避免进行扩大切除术。在大多数这类患者中，可通过内镜实现令人满意的姑息治疗。可切除胰腺肿瘤的手术治疗指征基于经验丰富的中心胰十二指肠切除术死亡率远超过5%这一情况。改进的手术技术、改善的围手术期管理以及准确的术前危险因素分析的实施，使得原发性胰腺肿瘤的切除具有较低的发病率和死亡率。
