目的:异位胰腺,在儿童中不常见的情况,可能面临诊断和治疗挑战。本研究旨在评估儿科患者这种疾病的临床特征和治疗选择。
方法:我们进行了回顾性分析,包括2000年1月至2022年6月在四家三级医院诊断为异位胰腺的患者。根据临床表现将患者分为有症状组和无症状组。临床参数,包括手术年龄,病变大小和部位,手术或内窥镜入路,病理结果,和结果,进行了统计分析。
结果:该研究包括88例异位胰腺患者。其中,22有症状,和41岁的年龄在一岁或更小。异位胰腺通常位于Meckel憩室(46.59%),空肠(20.45%),脐部(10.23%),回肠(7.95%),胃(6.82%)。66例患者有伴随疾病。33例患者的异位胰腺位于Meckel憩室,80.49%的病例伴有胃粘膜异位症(GMH)。没有伴有GMH的患者异位胰腺相关症状的患病率更高(75%)。治疗方式包括通过开放手术切除病变,腹腔镜或腹腔镜辅助手术,或根据患者年龄进行内窥镜手术,病变部位和大小,和共存的疾病。
结论:只有四分之一的异位胰腺患者出现症状。那些位于梅克尔憩室的人通常伴有GMH。开腹手术,由于潜在的并发症,建议腹腔镜手术或内镜下异位胰腺切除术。未来的前瞻性多中心研究有必要建立合理的治疗方案。
OBJECTIVE: Heterotopic pancreas, an uncommon condition in children, can present with diagnostic and treatment challenges. This
study aimed to evaluate the clinical features and treatment options for this disorder in pediatric patients.
METHODS: We conducted a retrospective analysis, including patients diagnosed with heterotopic pancreas at four tertiary hospitals between January 2000 and June 2022. Patients were categorized into symptomatic and asymptomatic groups based on clinical presentation. Clinical parameters, including age at surgery, lesion size and site, surgical or endoscopic approach, pathological findings, and outcome, were statistically analyzed.
RESULTS: The
study included 88 patients with heterotopic pancreas. Among them, 22 were symptomatic, and 41 were aged one year or younger. The heterotopic pancreas was commonly located in Meckel\'s diverticulum (46.59%), jejunum (20.45%), umbilicus (10.23%),ileum (7.95%), and stomach (6.82%). Sixty-six patients had concomitant diseases. Thirty-three patients had heterotopic pancreas located in the Meckel\'s diverticulum, with 80.49% of cases accompanied by gastric mucosa heterotopia (GMH). Patients without accompanying GMH had a higher prevalence of heterotopic pancreas-related symptoms (75%). Treatment modalities included removal of the lesions by open surgery, laparoscopic or laparoscopic assisted surgery, or endoscopic surgery based on patient\'s age, the lesion site and size, and coexisting diseases.
CONCLUSIONS: Only one-fourth of the patients with heterotopic pancreas presented with symptoms. Those located in the Meckel\'s diverticulum have commonly accompanying GMH. Open surgical, laparoscopic surgical or endoscopic resection of the heterotopic pancreas is recommended due to potential complications. Future prospective multicenter studies are warranted to establish rational treatment options.