目的 探讨内镜下治疗胆管乳头状瘤的价值。方法 6例经病理学检查证实的胆管乳头状瘤患者在行“胆道探查+ T管引流术”后6～8周行胆道镜下高频电刀烧灼术，对术后治疗效果进行评估。结果 6例患者术后胆汁引流量逐渐增多至100～400 ml/d(平均250 ml/d)，胆汁黏稠度明显减轻，黄疸减退。术后随访1～3年，平均2年，3例患者术后黄疸、腹痛明显减轻，至今无复发； 2例在继续治疗中； 1例患者随访半年，T管引流通畅，但因严重肺部感染并发多器官功能衰竭死亡。结论 内镜下高频电刀烧灼治疗胆管乳头状瘤能有效缓解患者的临床症状，明显提高患者的生存质量。
目的 总结胰腺实性假乳头状瘤再次手术病例的诊断和治疗经验。方法 回顾性分析2002年12月至2011年12月期间笔者所在医院收治的4例胰腺实性假乳头状瘤再次手术患者的临床资料。结果 4例患者均行手术治疗，术后恢复良好，随访时间3个月～8年，平均47个月。至2012年3月，3例患者分别无瘤生存3个月、3个月以及8年；1例患者于术后8年死于营养吸收障碍，死亡时无肿瘤复发。结论 胰腺实性假乳头状瘤具有低度恶性倾向，以局部复发为主，远处转移少见。手术是复发、转移病例的最佳选择，具有较好疗效。
ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
目的 观察独用内镜下手术以及联合等离子低温射频治疗外耳道乳头状瘤的疗效。 方法 2006年7月－2010年7月，随机将收治的45例外耳道乳头状瘤患者（150只耳）分组，比较独用内镜下手术组（A组）以及联合等离子低温射频组（B组）治疗外耳道乳头状瘤的疗效。 结果 患者均术后成功随访1～3年，48只患耳无复发及恶变，2只患耳3个月后复发。 结论 内镜下手术联合等离子低温射频治疗外耳道乳头状瘤具有微创，手术彻底有效，防止复发的优点，值得临床广泛应用。
目的：探讨鼻内镜手术治疗鼻内翻性乳头状瘤(NIP)的疗效。方法：回顾性分析用鼻内镜手术治疗的36例经病理确诊的NIP患者的临床资料，随访1～6年。结果:”一次性治愈31例(86.1%)；5例复发(13.9%)，3例在门诊内窥镜下分次摘除并结合YAG激光治愈，2例再次于鼻内镜结合Caidwell-Luc手术治疗，无恶变病例，结论：根据病变范围选择适当的手术方式，经鼻内镜手术切除鼻腔鼻窦内翻性乳头状瘤效果良好。
Objective To discuss the methods of diagnosis and treatment of cystic neoplasms of pancreas. Methods Demographic data, clinical manifestations, diagnostic exams, surgical procedures, pathological diagnosis, postoperative complications, and follow-up data of 29 patients with cystic neoplasms of pancreas were analyzed retrospectively. Results There were 8 （28%） serous cystic tumors （SCN）, 12 （41%） mucinous cystic tumors （MCN）, 3 （10%） intraductal papillary mucinous tumors （IPMN）, and 6 （21%） solid pseudopapillary tumors （SPT）. Eight cases of SCN, 7 cases of MCN, 1 case of IPMN, and 5 cases of SPT were all benign. The ages of the patients were from 15 to 78 years〔average, （49±17）years〕and all tumors were more common in female （76%, 22/29）. Twenty-three cases of 29 patients were performed operations, 22 cases were underwent surgical resection, and 1 case was performed exploration and biopsy. There was no surgery-related death. The rest 6 cases were not performed operation. Twenty-one cases followed-up for 6 months to 8 years 〔average, （2.7±2.3） years〕, 8 cases didn’t followed-up. Sixteen cases with surgical resection had no recurrence during follow-up period, 1 case performed exploration and biopsy died in 1 year after operation, and 4 cases of SCN without surgery didn’t deteriorate. Conclusions The most common cystic neoplasms of pancreas are mucinous and serous cysts. These tumors are more frequent in female. Although almost all serous cysts are benign, 42% of mucinous cysts are malignant. Misdiagnosis may delay appropriate treatment and increase mortality. The resection rate of pancreatic cystic tumor is high, and the prognosis is good after radical resection.
目的总结胰腺实性假乳头状瘤的临床特点及诊治体会。方法回顾性分析2000年5月至2010年5月期间在我科手术治疗并经病理检查证实的8例胰腺实性假乳头状瘤患者的临床资料。结果3例肿瘤位于胰头部者行胰十二指肠切除术; 2例肿瘤位于胰颈部者行单纯肿瘤摘除术; 1例肿瘤位于胰体部者行胰腺中段切除、近端闭合、远端与空肠行吻合术; 2例位于胰尾部者行胰体尾切除联合脾脏切除术。 术中未见腹腔脏器转移。8例患者术后经病理检查均证实为胰腺实性假乳头状瘤。 术后均未行放、化疗。 本组患者随访1~10年（平均5.5年），除2例失访外，其余均健在。 结论胰腺实性假乳头状瘤临床少见，属低度恶性肿瘤，女性多见； CT及MRI是其主要的影像学检查手段； 手术切除预后较好。
目的 分析6例胰腺实性假乳头状瘤病例，探讨其诊断、治疗方法。方法 对我院2005年1月至2008年6月期间收治的6例胰腺实性假乳头状瘤病例的临床资料进行回顾性分析。结果 6例患者年龄15～42岁，平均26.7岁； 其中男1例，女5例。 肿瘤位于胰头2例，胰体尾部4例。 无特异性临床表现。 血清肿瘤标志物均为阴性。 2 例行胰十二指肠切除术，4例行胰体尾及脾切除术。6例患者均获随访，随访时间6～48个月，平均24个月，均未发现肿瘤复发、转移。 结论 胰腺实性假乳头状瘤是一种罕见的低度恶性胰腺肿瘤，多发于青年女性； 术前、术中明确诊断有助于术式的选择，提高患者的生存质量。