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纸质出版:2013
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张莉敏,樊超强,赵晶京,张传涛,杨仕明.内镜下微创诊治58例胃异位胰腺临床分析[J].陆军军医大学学报(原第三军医大学学报),2013,35(15):1629-1632.
Zhang Limin,Fan Chaoqiang,Zhao Jingjing,Zhang Chuantao,Yang Shiming.Diagnosis and minimally invasive treatment of ectopic pancreas: report of 58 cases[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(15):1629-1632.
张莉敏,樊超强,赵晶京,张传涛,杨仕明.内镜下微创诊治58例胃异位胰腺临床分析[J].陆军军医大学学报(原第三军医大学学报),2013,35(15):1629-1632. DOI:
Zhang Limin,Fan Chaoqiang,Zhao Jingjing,Zhang Chuantao,Yang Shiming.Diagnosis and minimally invasive treatment of ectopic pancreas: report of 58 cases[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(15):1629-1632. DOI:
目的 分析胃异位胰腺内镜下特点,评估内镜下黏膜切除术(endoscopic mucosal resection
EMR)和内镜下黏膜剥离术(endoscopic submucosal dissection
ESD)对胃异位胰腺的治疗价值。 方法 回顾性分析第三军医大学新桥医院2008年11月至2012年11月内镜下切除且病理诊断明确的58例胃异位胰腺病例资料,其中男性23例,女性35例,平均39.6(14~75)岁,包括行EMR 20例和行ESD 38例,总结其内镜特点,比较EMR和ESD的治疗效果。 结果 部分患者以上腹部隐痛、腹胀为主诉;均单发黏膜下包块,表面完整,典型者可有中心脐样凹陷,占27.6%(16/58);超声内镜发现多来源第3层,回声不均匀,有时与固有肌层分界不清,超声内镜与术后病理诊断均一致,达100%(58/58)。行EMR 20例,复发率20.0%(4/20),无并发症;行ESD 38例,无复发,2例术中出血和2例穿孔。ESD与EMR治疗胃异位胰腺相比,复发率低(
P
0.01),并发症发生率较高。 结论 超声内镜对胃异位胰腺诊断率高,ESD治疗胃异位胰腺较EMR复发率低,但并发症发生率较高。
Objective To analyse the endoscopic characteristics and evaluate the value of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for ectopic pancreas in stomach. Methods Data of 58 patients(including EMR 20 cases and ESD 38 cases) with endoscopic dissected and pathologically confirmed ectopic pancreas was studied in our hospital from November 2008 to November 2012. The features of the ectopic pancreas were summarized and effect of EMR and ESD were compared. Results Totally of 58 cases in which the mean age o
f the patient was 39.6 (ranging 14 to 75) with M/F ratio of 35/23. Epigastric pain and abdominal distension were the common presentations. Most of the lesions detected were located as a single mass within the stomach. Of which were characterized by protrusion
with intact mucous membrance and centrally umbilicated(27.6%
16/58). Ultrasonography findings were heterogeneous and mixed echogenic lesions with indistinct borders involving both the second and third layers of the gastric wall
sometimes even involving the first and fourth layers. Twenty cases were removed by EMR without complication
and the recurrence rate was 20.0%(4/20). Thirty-eight cases were removed by ESD with 2 cases of bleeding 5.26%(2/38) and 2 cases of perforations 5.26%(2/38)
but without recurrence. ESD for ectopic pancreas of stomach has low recurrence rate(
P
0.05)and higher complication rate than EMR. Conclusion Diagnosis rate of the ectopic pancreas of stomach with EUS is of high level.ESD for ectopic pancreas of stomach has low recurrence rate and higher complication rate than EMR.
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