{"title":"胰腺实性假乳头状肿瘤的外科治疗——来自三级医疗中心的经验","authors":"Rohit Bhatta, Santosh Irrinki, Vikas Gupta, Thakur Deen Yadav, Yashwant Raj Sakaray, Hemanth Kumar, Ritambhra Nada, Harjeet Singh","doi":"10.1007/s13193-023-01805-w","DOIUrl":null,"url":null,"abstract":"<p><p>Solid pseudopapillary neoplasm (SPN) is uncommon and constitutes to 1-2% of pancreatic tumours. Owing to its rarity, literature is sparse on its clinicopathological characteristics and surgical outcomes. Our study is a retrospective analysis of prospectively maintained data of patients with histologically proven SPN between January 2012 and December 2019. Patients' demography, clinical presentation, preoperative imaging, operative details, perioperative outcomes, and long-term follow-up were recorded and analyzed. A total of 14 patients were included in the study, all were females with a median age of 19.5 years (range 15-35 years). All presented with pain abdomen. Eight (57.1%) out of 14 patients were correctly diagnosed with contrast-enhanced computed tomography (CECT) abdomen. CECT revealed solid cystic well-encapsulated lesions in 12(85.7%) and homogenous mass lesions without cystic changes in 2 (14.2%) patients. The most common tumour location was head/uncinate process (57.1%). Eight (57.1%) underwent pancreaticoduodenectomy and 6 (42.8%) had undergone distal pancreatectomy. The median size of tumour was 10 cm (4.5-14 cm). The median postoperative stay was 9 days (range 4-20 days). Seven patients (50%) developed postoperative pancreatic fistula (Grade-A-6/7, Grade-B-1/7) and delayed gastric emptying (DGE) was noted in two (14.2%). R0 resection could be achieved in 13 patients (92.8%). Median follow-up period was 49.5 months. One patient had postoperative recurrence after 48 months of surgery. SPN is a rare tumour of pancreas. Surgical resection is associated with acceptable morbidity and is required for potential cure.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":" ","pages":"502-507"},"PeriodicalIF":0.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052694/pdf/","citationCount":"0","resultStr":"{\"title\":\"Surgical Management of Solid Pseudopapillary Neoplasm of the Pancreas-an Experience from Tertiary Care Centre.\",\"authors\":\"Rohit Bhatta, Santosh Irrinki, Vikas Gupta, Thakur Deen Yadav, Yashwant Raj Sakaray, Hemanth Kumar, Ritambhra Nada, Harjeet Singh\",\"doi\":\"10.1007/s13193-023-01805-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Solid pseudopapillary neoplasm (SPN) is uncommon and constitutes to 1-2% of pancreatic tumours. Owing to its rarity, literature is sparse on its clinicopathological characteristics and surgical outcomes. Our study is a retrospective analysis of prospectively maintained data of patients with histologically proven SPN between January 2012 and December 2019. Patients' demography, clinical presentation, preoperative imaging, operative details, perioperative outcomes, and long-term follow-up were recorded and analyzed. A total of 14 patients were included in the study, all were females with a median age of 19.5 years (range 15-35 years). All presented with pain abdomen. Eight (57.1%) out of 14 patients were correctly diagnosed with contrast-enhanced computed tomography (CECT) abdomen. CECT revealed solid cystic well-encapsulated lesions in 12(85.7%) and homogenous mass lesions without cystic changes in 2 (14.2%) patients. The most common tumour location was head/uncinate process (57.1%). Eight (57.1%) underwent pancreaticoduodenectomy and 6 (42.8%) had undergone distal pancreatectomy. The median size of tumour was 10 cm (4.5-14 cm). The median postoperative stay was 9 days (range 4-20 days). Seven patients (50%) developed postoperative pancreatic fistula (Grade-A-6/7, Grade-B-1/7) and delayed gastric emptying (DGE) was noted in two (14.2%). R0 resection could be achieved in 13 patients (92.8%). Median follow-up period was 49.5 months. One patient had postoperative recurrence after 48 months of surgery. SPN is a rare tumour of pancreas. 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引用次数: 0
摘要
实性假乳头状肿瘤(SPN)并不常见,约占胰腺肿瘤的1-2%。由于其罕见性,文献对其临床病理特征和手术结果的研究较少。我们的研究是对2012年1月至2019年12月组织学证实的SPN患者的前瞻性数据进行回顾性分析。记录和分析患者的人口学、临床表现、术前影像学、手术细节、围手术期结局和长期随访。研究共纳入14例患者,均为女性,中位年龄19.5岁(15-35岁)。均表现为腹部疼痛。14例患者中有8例(57.1%)腹部ct正确诊断。CECT显示12例(85.7%)为实性囊性包被病变,2例(14.2%)为均质性肿块,无囊性改变。最常见的肿瘤部位为头钩突(57.1%)。8例(57.1%)行胰十二指肠切除术,6例(42.8%)行远端胰切除术。肿瘤中位大小为10 cm (4.5 ~ 14 cm)。术后中位住院时间为9天(范围4-20天)。7例(50%)患者出现术后胰瘘(a -6/7级,b -1/7级),2例(14.2%)患者出现胃排空延迟。R0切除13例(92.8%)。中位随访期为49.5个月。1例患者术后48个月复发。SPN是一种罕见的胰腺肿瘤。手术切除与可接受的发病率相关,并且需要潜在的治愈。
Surgical Management of Solid Pseudopapillary Neoplasm of the Pancreas-an Experience from Tertiary Care Centre.
Solid pseudopapillary neoplasm (SPN) is uncommon and constitutes to 1-2% of pancreatic tumours. Owing to its rarity, literature is sparse on its clinicopathological characteristics and surgical outcomes. Our study is a retrospective analysis of prospectively maintained data of patients with histologically proven SPN between January 2012 and December 2019. Patients' demography, clinical presentation, preoperative imaging, operative details, perioperative outcomes, and long-term follow-up were recorded and analyzed. A total of 14 patients were included in the study, all were females with a median age of 19.5 years (range 15-35 years). All presented with pain abdomen. Eight (57.1%) out of 14 patients were correctly diagnosed with contrast-enhanced computed tomography (CECT) abdomen. CECT revealed solid cystic well-encapsulated lesions in 12(85.7%) and homogenous mass lesions without cystic changes in 2 (14.2%) patients. The most common tumour location was head/uncinate process (57.1%). Eight (57.1%) underwent pancreaticoduodenectomy and 6 (42.8%) had undergone distal pancreatectomy. The median size of tumour was 10 cm (4.5-14 cm). The median postoperative stay was 9 days (range 4-20 days). Seven patients (50%) developed postoperative pancreatic fistula (Grade-A-6/7, Grade-B-1/7) and delayed gastric emptying (DGE) was noted in two (14.2%). R0 resection could be achieved in 13 patients (92.8%). Median follow-up period was 49.5 months. One patient had postoperative recurrence after 48 months of surgery. SPN is a rare tumour of pancreas. Surgical resection is associated with acceptable morbidity and is required for potential cure.
期刊介绍:
The Indian Journal of Surgical Oncology aims to encourage and promote clinical and research activities pertaining to Surgical Oncology. It also aims to bring in the concept of multidisciplinary team approach in management of various cancers.
The Journal would publish original article, point of technique, review article, case report, letter to editor, profiles of eminent teachers, surgeons and instititions - a short (up to 500 words) of the Cancer Institutions, departments, and oncologist, who founded new departments.