Diagnosis and treatment of chronic pancreatitis with mass in the head ofpancreas
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R 576; R 735.9

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    Abstract:

    Abstract:Objective :To study the diagnosis and treatment of chronic pancreatitis with mass in the head of pancreas (CPMHP ). Methods :The clinical material of 29 patients of CPMHP confirmed by operation and pathology were analyzed. Results :In the 29 cases, habitual alcohol consumption accounted for 16 cases, cholelithiasis for 12 cases and idiopathic pancreatitis for 1 case. The diagnostic methods included laboratory examination, CT or helical CT, PTC or ERCP. Before operation, 21 cases were diagnosed as CPMHP and 8 cases were diagnosed as carcinoma of pancreatic head (PhCa), but all of the patients were diagnosed as CPMHP by intraoperative biopsy. All of the 29 patients received operation, including Whipple′s operation in 11 cases, Beger′s operation in 6 cases, and choledochotomy in 12 cases. After operation, the pancreatic fistula rate was 5.9%, and there was no operative death in this series. All of the patients were followed up for a mean of 5 years. One case was found to have PhCa at re-operation 5 years later, and one case died of diabetetic complication after 7 years. Conclusions :It is very difficult to differentiate between PhCa and CPMHP, but the clinical features in combination with CT and ERCP findings are helpful, while intraoperative biopsy is the most sensitive method of differentiation. Since CPMHP can undergo cancerous change, it is advised that a mass in the head of pancreas should be removed by surgery.

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SHI Quan, CHEN Jing-fan, LON Chen-meng .Diagnosis and treatment of chronic pancreatitis with mass in the head ofpancreas [J]. Chin J Gen Surg,2006,15(11):4-812.
DOI:10.7659/j. issn.1005-6947.2006.11.004

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History
  • Received:January 01,1900
  • Revised:January 01,1900
  • Adopted:
  • Online: November 25,2006
  • Published: