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

Objective To discuss the preoperative diagnostic features and surgical treatment of chronic pancreatitis (CP) with mass in the head of the pancreas.Methods A retrospective analysis of our hospital clinical data of patients with pancreatic head tumors treated nearly eight years, through the clinical manifestations and biochemical indexes analysis, and imaging studies, summed up the difference between chronic pancreatitis with mass in the head of the pancreas and pancreatic cancer, and by analyzing its treatment and complications, to make optimum surgical treatment optionsResults A total of 90 cases of pancreatic tumors treated patients,16 cases chronic pancreatitis with mass in the head of the pancreas,74 cases of pancreatic cancer. About the clinical manifestations between the two groups, CP group with abdominal pain as the main symptom(62.5%), incidence of jaundice lower (P<0.05); With respect to abnormally elevated CA19-9, CP with mass in the head of the pancreas was lower, the difference was statistically significant (P<0.05); On the imaging findings, MRCP imaging showed mild degree of bile duct dilatation, gradually stricture of bile duct and beaded dilatation of pancreatic duct,suggesting that the lesion is benign. The others no significant differences. All patients eventually underwent radical pancreaticoduodenectomy (Child Act), in which the head of the pancreas mass in CP group,2 cases intending to Beger surgery, owing to difficult to handle and bleeding into PD surgery. Compared with pancreatic cancer, postoperative complications and the length of stay and hospital costs was no significant difference in length of stay and hospital costs(P>0.05).Conclusions Preoperative diagnosis of CP with mass in the head of the pancreas is difficult.For the the primary symptoms of abdominal pain, jaundice is not heavy, and no significant increase in CA19-9 (CA19-9<35), enhanced CT delayed of the lesion and the surrounding normal pancreatic tissue contrast is not obvious, MRCP display bile duct dilatation to a lesser degree,gradually narrowing, no more intrahepatic bile duct dilatation, suggesting that the lesion is chronic pancreatitis. For the treatment of CP, the radical pancreaticoduodenectomy as the main method, compared to Berger surgery, PD is more safe and easy.