PANCREATODUODENECTOMY FOR SOLID PSEUDOPAPILLARY TUMOR OF THE PANCREAS: A MULTI-INSTITUTION STUDY

ABSTRACT Background: Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. Most patients present with nonspecific symptoms until the tumor becomes large. Complete surgical resection by pancreatoduodenectomy is the treatment of choice for tumors located in the head of the pancreas Aim: To analyzed the clinicopathologic features, management, and outcomes of patients who had solid pseudopapillary tumor of the head pancreas and underwent surgical resection. Methods: Were analyzed 16 patients who underwent pancreatoduodenectomy for this condition. Results: Mean age was 25.7 years old, and 15 patients were female (93.7%). Nonspecific abdominal pain was present in 14 (87.5%). All underwent computed tomography and/or magnetic resonance imaging as part of diagnostic workup. The median diameter of the tumor was 6.28 cm, and surgical resection was performed with open or laparoscopic pancreatoduodenectomy without neoadjuvant chemotherapy. Postoperative complications occurred in six patients (37.5%) and included pancreatic fistula without mortality. The mean of hospital stay was 10.3 days. Median follow-up was 3.6 years, and no patient had local recurrence or metastatic disease. Conclusion: For these patients surgical resection with pancreatoduodenectomy is the treatment of choice showing low morbidity, no mortality, and good long-term survival.

摘要 背景：胰腺实性假乳头状瘤（solid pseudopapillary tumor of the pancreas）是一种罕见的低度恶性肿瘤。多数患者在肿瘤体积增大前仅表现为非特异性症状。对于胰头部肿瘤，采用胰十二指肠切除术（pancreatoduodenectomy）的完整手术切除是首选治疗方案。
研究目的：分析接受手术切除的胰头部实性假乳头状瘤患者的临床病理特征、诊疗策略及预后结局。
研究方法：本研究纳入16例因该病接受胰十二指肠切除术的患者进行回顾性分析。
研究结果：患者平均发病年龄为25.7岁，其中女性15例（占比93.7%）；14例（87.5%）存在非特异性腹痛。所有患者均接受计算机断层扫描（computed tomography，CT）和/或磁共振成像（magnetic resonance imaging，MRI）作为诊断评估手段。肿瘤中位直径为6.28cm，所有患者均行开放或腹腔镜胰十二指肠切除术，未接受新辅助化疗（neoadjuvant chemotherapy）。6例（37.5%）患者出现术后并发症，其中包括胰瘘（pancreatic fistula），无手术相关死亡病例。患者平均住院时长为10.3天。中位随访时间为3.6年，所有患者均未出现局部复发或远处转移。
研究结论：针对此类患者，胰十二指肠切除术是首选治疗方案，该术式并发症发生率低、无手术死亡，且可获得良好的长期生存预后。