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目的 探讨胰腺、Vater壶腹周围癌术中确诊方法。方法 对 2 2 4例胰腺、Vater壶腹周围癌术中确诊方法进行回顾性分析。结果 行穿剌细胞学、穿剌组织学活检 16 6例 ,阳性 134例 (80 7% ) ;切取肿瘤组织活检6 5例 ,阳性 6 0例 (92 3% ) ;切取肝转移灶活检 2 6例 ,全部阳性 ;淋巴结活检 32例 ,阳性 18例 (5 6 2 % ) ;胆汁细胞学检查 10例 ,阳性 4例 (40 % ) ;刮取胆总管肿瘤组织活检 8例 ,阳性 5例 (6 2 5 % ) ;术中胆道镜活检 7例 ,阳性 5例 (71 4% )。结论 穿剌细胞学、组织学活检是胰腺、Vater壶腹周围癌术中确诊首选方法 ,根据肿瘤部位、生长方式等采取相应方法可达确诊目的。
Objective To investigate the diagnosis of pancreatic and Vater periampullary carcinoma during operation. Methods A retrospective analysis of the diagnosis of 241 ampullary carcinomas of the pancreas and Vater was performed. The results of perforation cytology, puncture histological biopsy 166 cases, positive 134 cases (80 7%); cut biopsy of tumor tissue in 65 cases, positive in 60 cases (92 3%); cut liver biopsy 2 6 Cases, all positive; Lymph node biopsy in 32 cases, positive in 18 cases (5 62%); bile cytology in 10 cases, positive in 4 cases (40%); scraping bile duct tumor biopsy in 8 cases, positive in 5 cases (6 25% ); intraoperative biopsy of bile duct biopsy in 7 cases, positive in 5 cases (71 4%). Conclusion Percutaneous craniotomy and histological biopsy are the preferred methods for diagnosis of pancreatic and Vater periampullary carcinoma. The corresponding methods can be used to achieve the purpose of diagnosis based on the tumor site and growth pattern.