Diagnosis and treatment of chronic pancreatitis with mass in the head of the pancreas

Jie Yin, Zhong-tao Zhang
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Abstract

Chronic pancreatitis (CP) with mass and pancreatic cancer are difficult to identify from the Clinical performance. Imaging methods in the diagnosis of the CP with mass play an important role, which is very helpful for the indications for surgery of the hands, of resectable pancreatic head tumor, and surgical options, as well as estimates of the difficulty of the surgery. At present, we have taken the CP with mass as a precancerous lesion of pancreatic cancer. Surgical strategy in CP with mass has been directed at the pancreatic head with a variety of tactics including pancreatoduodenectomy ( Whipple procedure with or without pylorus preservation) and partial resection of the pancreatic duct drainage( Frey operation, Beger operation ). Once the diagnosis of the CP with mass was confirmed surgical treatment should be performed by pancreatoduodenectomy, which by not only the pancreatic head mass was resected, the bile ducts and pancreatic ducts and obstruction of the duodenum were lifted, but also the potential causes of pancreatic cancer were ruled out. Pancreatoduodenectomy has great risk for the big mass of pancreatic head, but the partial head resection can be accomplished with relative safety. Key words: Pancreatitis;  Pancreatoduodenectomy
慢性胰腺炎伴胰头肿块的诊断与治疗
慢性胰腺炎伴肿块和胰腺癌的临床表现难以区分。影像学方法在CP伴肿块的诊断中起着重要的作用,对手部手术指征、可切除胰头肿瘤的手术选择、手术难度的估计都有很大的帮助。目前,我们认为有肿块的CP是胰腺癌的癌前病变。有肿块的CP的手术策略是针对胰头的,包括胰十二指肠切除术(Whipple手术,保留或不保留幽门)和部分切除胰管引流(Frey手术,Beger手术)。一旦确诊CP伴肿块,应行胰十二指肠切除术,切除胰头肿块,解除胆管、胰管及十二指肠梗阻,排除胰腺癌的潜在病因。胰十二指肠切除术对胰头肿物大风险大,部分胰头切除相对安全。关键词:胰腺炎;Pancreatoduodenectomy
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