| Background and Objective:This study retrospectively analyzed the tumor size,location,location of the main pancreatic duct and the choice of corresponding surgical resection method of solid pseudopapillary tumor of pancreas(SPTP),and compared the treatment effect of simple tumor resection and regular tumor resection,so as to provide ideas for the selection of clinical treatment options for solid pseudopapillary tumor of pancreas Methods:From 2013 to 2018,a total of 45 patients who were definitely diagnosed as solid pseudopapillarytumor of pancreas and received surgical treatment in the second hospital of Jilin University and China-Japan Friendship hospital of Jilin University were selected.The patients were divided into two groups according to the rule of resection and tumor resection.The rule of resection included pancreaticoduodenectomy(11 cases),pancreaticoduodenectomy(2 cases),pancreaticoduodenectomy(4 cases),pancreaticocaudal resection + splenectomy(11 cases),and pancreaticocaudal splenectomy(7 cases).The tumor resection group(with or without a small amount of normal pancreatic tissue)had a total of 10 cases.The relationship between the tumor and the position of the main pancreatic duct(whether the main pancreatic duct was compressed),intraoperative blood loss,duration of surgery,length of hospital stay and postoperative complications(mainly pancreatic fistula)were compared and analyzed.Result:According to the statistical results in this paper,there were 6 male patients and 39 female patients,and male patients accounted for 13.3% of the total number of patients,and female patients accounted for 86.7% of the total number of patients,with the age(33.5±10.9)years old.There were 3 cases of male malignant SPTP and 7 cases of female malignant SPTP.After statistical analysis,gender had no statistical significance for benign and malignant tumor tendency.In this study,there were 17 patients with tumor diameter greater than 5cm,including 8 patients(47.1%)with malignant postoperative pathological return,28 patients with tumor diameter less than 5cm,and 2 patients(7.14%)with malignant postoperative pathological return.Compared with tumor diameter less than 5 cm,tumor diameter greater than 5 cm had a malignant tendency,and the results were statistically different(P =0.006).Two patients with preoperative diameter less than 5cm and postoperative pathology confirmed malignant tumors,with diameters of 4.6cm and 4.8cm,respectively.The length of hospital stay(13.6±2.5 days),intraoperative blood loss(100±30ml),and duration of surgery(116±26minutes)in patients undergoing tumor resection alone were lower than those in the regular resection group,P < 0.05,and the difference was statistically significant.In this study,postoperative pancreatic fistula was mainly distributed in pancreatic-head duodenectomy(2 cases of grade A pancreatic fistula and 2 cases of grade B pancreatic fistula),mid-pancreas resection(2 cases of grade A pancreatic fistula and 1 case of grade B pancreatic fistula),pancreatic-body and tail + splenectomy(1 case of grade A pancreatic fistula)and simple tumor resection(2 cases of grade A pancreatic fistula).There was no statistically significant difference in the incidence of pancreatic fistula between regular resection and tumor resection alone(P=0.83).Conclusion:1.In this study,the tumor diameter of 5cm can be taken as one of the indicators for preliminary classification of benign and malignant tumors,and the tumor diameter of > 5cm is highly likely to be malignant.2.Compared with regular resection,simple tumor resection has the advantages of shorter operation time,less intraoperative blood loss and shorter hospital stay.However,in postoperative complications of pancreatic fistula,there is no significant difference between regular resection and simple tumor resection.Therefore,under the premise ofexcluding the possibility of malignancy,and the tumor does not compress the main pancreatic duct,simple tumor resection can be preferred. |
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