Study On The Diagnosis And Treatment Of Distal Pancreatic Neoplasms

The development of image technology has enhanced the discovery rate of distadptebootnrrxcfieaeeef accnofaadaemapcttisrmmurlaieaiesnogeensaeannmnntt ti oittiacos .oos ol .fi nfT fsno sh tdfse,h e tuiodlosea rpitgp bgsalearotsilac esthrphlamoao aleppt rnsorateo,a cr nrprgywwaceee trtiahri etevathioasiectc ttfih si otdnc hnca iehhnea.no a gaedFpsnrro o laaiaopmretcssli axtmotaetspinhgcrm ob aeiisssr lsyti esa. ti idrmtycTmee h eaomtuoeashflrfont oe aenstr dnfr b,olioe eisirmawfodte atru ime,le ts pi astplettay eriniat,oasy tnt tren nchcr tareheononecni ,fa nde e tsg chxiqslc tapiukao nsliarn o inylecergid afetortfsalo aep tots cilrfahvpftia seene dimd dstidsh edi int iietiatasasg hl gg srreprnn,ee aaooaaarpncssssehcicioolssryuynn es raaaaailaocbbnntcwaillddyeecllPart one:Diagnosis and treatment of distal pancreaticendocrine tumorsObjective To discuss the clinical characteristics and treatment of distal pancreatic endocrine tumors.Methods The clinical data of 5 patients with distal pancreatic endocrine tumors , which confirmed by postoperative pathology, were analyzed retrospectively.Results In a total of 5 cases, there were 3 cases of insulinomas, 1 glucagonoma and 1 MEN. 4 of them were examined by ultrasonography and only one case was proved to be space‐occupying lesion. 3 of them were examined by CT or MRI, all of them were proved to be space‐occupying lesions. All cases had spleen preserving distalpancreatectomy. The other operations include adrenalectomy and subtotal thyroidectomy. Conclusion The best treatment of pancreatic endocrine tumor is to resect mass complete. PET often can be located by imaging examination. Pre‐operative qualitative diagnosis should be emphasized.Part two:Diagnosis and surgical therapy of pancreatic body and tail carcinomaObjective To explore the diagnosis and surgery therapy of pancreatic body and tail carcinoma.Methods The clinical data of 4 cases of tumor of distal pancreas which underwent operation were analyzed.Results The main clinical manifestations of distal pancreas cancer were abdominal pain, backache, emaciation and weakness. Ultrasonography, CT and MRI were the main methods to diagnose pancreatic body and tail carcinoma. Imaging and tumor marker detection can give exact diagnosis of tumor.Conclusion Combined imaging and serum detection can enhance the findings of distal pancreatic malignancy. Radical resection is the unique method for long survival. Part three: Diagnosis and differential diagnosis of distal pancreatic cystic neoplasmObjective To explore the diagnosis and differential diagnosis of distal pancreatic cystic neoplasms.Methods Nine cases of distal pancreatic cystic neoplasm admitted to our hospital were analyzed retrospectively.Results Of all nine patients in this group, only 1 was definitely diagnosed as cystic tumor of the pancreas preoperatively, 8 were diagnosed as pseudocyst. The body and tail of the pancreas and the spleen were resected in 3 patients, and 6 cases were undergone spleen preserving distal pancreatectomy.Conclusion We can improve the correct diagnosis rate by comprehensively analyzing the clinical character,images of pancreas, and biochemistry and exfoliative cytology of cyst fluid.Part four: Distal pancreatectomy for neoplasmObjective To probe the surgical treatment of distal pancreatic neoplasm.Methods Twenty‐four patients with distal pancreatectic neoplasm form November 2001 to May 2009 in our hospital were retrospectively analyzed. Result 10 males and 14 females were included in this group, with the average age of 43. Nine cases were confirmed to be benign. 15 cases had spleen‐reservation and 9 patients underwent splenectomy. The other operations include gastrectomy, adrenalectomy, colon and partial liver resection.Conclusion Distal pancreatectomy is one of the best choices to treat benign lesion of distal pancreas. The symptoms could be relieved by palliative procedure. Spleen‐preserving distal pancreatectomy is one safe and feasible treatment of benign and borderline tumors of pancreas.