ObjectiveTo summarize the effect of the multi-disciplinary treatment (MDT) for a patient with giant pancreatic cystic lymphangioma.MethodsThe clinical data of a patient with pancreatic lymphangioma admitted to the Affiliated Hospital of North Sichuan Medical College in March 2020 was retrospectively analyzed, then reviewed the literatures, and summarized the preoperative diagnosis, treatment, and management of perioperative period and long-term period after surgery of this rare disease.ResultsAfter admission, the patient was diagnosed as pancreatic tumor by various imaging and laboratory examinations. The nature was unknown. After discussion by MDT, it was decided to undergo a total pancreatectomy (TP). After the operation, drugs and diet were given to regulate blood glucose. The patient’s tumor disappeared after the operation, and no tumor recurrence was found in the three months after discharge.ConclusionsPancreatic lymphangioma is rare and lacks a clear diagnosis and treatment plan. The MDT mode can bring a clearer diagnosis and more effective treatment for it.
目的 探討腹膜后囊性淋巴管瘤的CT診斷價值和治療方法。方法 回顧性分析2004年6月至2010年5月期間我院收治的5例經病理檢查證實的腹膜后囊性淋巴管瘤患者的臨床表現、CT影像特征、手術治療及術后隨訪的資料。結果 5例患者術前CT均診斷為囊性淋巴管瘤，均行手術完整切除腫瘤，術后病理結果均證實為囊性淋巴管瘤。術后7 d順利出院，隨訪3個月～6年均無復發。結論 CT對腹膜后囊性淋巴管瘤的診斷具有重要意義，手術完整切除整個囊壁是治療及預防術后復發的最好方法。
目的 探討小兒結腸系膜淋巴管瘤的診斷與治療方法。方法 回顧性分析我院2006年1月至2011年12月期間手術治療的5例小兒結腸系膜淋巴管瘤的臨床資料。結果 3例診斷為腹腔包塊性質待查的患兒，術中發現腹腔腫塊來源于乙狀結腸系膜，其中1例腫塊侵犯到降結腸系膜達結腸脾曲而行左半結腸切除＋腸吻合術，另外2例行乙狀結腸系膜淋巴管瘤切除＋部分乙狀結腸切除＋腸吻合術；1例患兒診斷為急性化膿性闌尾炎合并乙狀結腸系膜淋巴管瘤，行闌尾切除＋乙狀結腸系膜淋巴管瘤切除＋腸吻合術，1例患兒診斷為乙狀結腸系膜淋巴管瘤破裂并彌漫性腹膜炎，行乙狀結腸系膜淋巴管瘤切除＋乙狀結腸造瘺術，術后6個月后再行二期手術。5例患兒手術后恢復良好，未發生吻合口漏等并發癥。術后隨訪5個月～5年， （2.3±1.1）年，1例失訪，余均存活，仍在隨訪中，所有病例均未復發。結論 日常行闌尾手術中，應常規探查小腸、結腸；未進行腸道準備的結腸一期吻合手術中結腸灌洗可減少吻合口漏等并發癥的發生率；腹腔感染嚴重的患兒結腸一期吻合不可取，結腸造瘺安全；小兒結腸系膜淋巴管瘤術前確診困難，反復出現腹痛、腹部包塊的患兒應想到結腸系膜淋巴管瘤的可能性，行充分的腸道準備后擇期手術，手術是腸系膜淋巴管瘤唯一的治療方法。