Diagnosis And Treatment Of Chronic Pancreatitis With Mass In Head Of Pancreas

To summarize the experiences of our hospital in diagnosis and therapeutic methods of chronic pancreatitis with mass in head of pancreas.MethodsClinical data of 12 patients with chronic pancreatitis with mass in head of pancreas who were hospitalized in the First Affiliated Hospital of China Medical University from 1990 to 2008 were analyzed retrospectively. Among the 12 cases, surgical treatment was performed in 9 cases. Pancreatic resection included:the pancreatic head nerve plexus surgical cut, cholecystectomy, common bile duct T-tube drainage, gallbladder jejunum anastomosis, pancreatic duct jejunum anastomosis, pancreatoduodenectomy, duodenum—preserving resection of the head of the pancreas.Results1 cases of common bile duct T tube drainage of patients recently was in good condition but the inflammatory mass in the pancreas persisted;2 cases of a routine pancreatic head nerve plexus cut and cholecystectomy in patients achieved postoperative pain relief;1 case treated by ERCP treatment had significant pain relief and jaundice disappeared,recurence of abdominal pain is a main problem in the patients undergoing simply drainage of the bile duct or pancreatic duct by choledoch ojejunostomy or pancreatic ojejunostomy;1 cases who performed duodenum-preserving subtotal resection of pancreatic head had postoperative pancreatic leakage, and had complete remission of symptoms,without abdominal pain and endocrine and exocrine insufficiency. pancreaticoduodenectomy were performed in 2 cases. Conclusions clinical manifestations of chronic pancreatitis with mass in head of pancreas and its imaging findings have a lack of specificity, but combination of ultra-endoscopy, needle aspiration biopsy, CT, and other eximinations can improve the preoperative positive diagnosis rate. surgical resection of a variety of head of pancreas-type have a good effect. Those patients who are difficult to rule out the appropriate line of malignant lesions should be performed pancreaticoduodenectomy, T-tube drainage of common bile duct, biliary-enteric anastomosis, pancreaticojejunostomy to relieve obstructive symptoms can still be short-term effect.