提高胰管结石合并胰腺癌的术前诊断率及外科治疗水平。

回顾性分析1989年1月至2009年1月经外科治疗的胰管结石合并胰腺癌患者16例的临床资料，总结临床特征、影像学诊断和手术方式。

胰管结石合并胰腺癌时，癌肿均发生于含结石胰管处。术前影像学诊断确诊率不高，B超、CT、内镜胰胆管造影（ERCP）和磁共振成像/磁共振胰胆管成像（MRI/MPCP）对本病的确诊率分别为31.2%（5/16）、68.8%（11/16）、66.7%（4/6）及60.0%（3/5）。16例患者均行手术治疗，无一例死亡，术后均获得随访3个月至6.5年，其1、3、5年生存率分别为62.5%（10/16）、18.8%（3/16）及6.2%（1/16）。手术切除和肿瘤分化程度是影响预后重要因素。

长期胰管结石反复发作是引起胰腺癌发生的重要原因；多种影像学联合检查及术中探查有助于提高胰管结石合并胰腺癌的确诊率；根治性手术是唯一可治愈本病的方法。

To improve the level of correct diagnosis and surgical treatment of pancreatic duct stone complicated with pancreatic cancer.

The clinical data of the 16 cases with pancreatic duct stone complicated with pancreatic cancer from January 1989 to January 2009 were analyzed retrospectively.

All of the tumors located in the pancreatic duct where the stone had taken place. Due to a lack of specific clinical manifestations, the preoperative diagnosis of this condition were difficult. In this series, the finaldiagnostic rate of pancreatic cancer before operation were 31.2%(5/16) by ultrasonography, 68.8%(11/16), by CT, 66.7%(4/6) by ERCP and 60%(3/5) by MRI/MRCP. All operations were successful. Postoperative follow-up were 3-78 months in 16 cases. The 1,3,5-year survival rates of cases were 62.5%(10/16), 18.8%(3/16) and 6.2%(1/16) respectively. Surgical excision and cell differentiation of pancreatic carcinoma were the important prognostic factors.

Patients with long-term recurrent pancreatic duct stone tend to have associated with pancreatic cancer. Combination of ultrasonography,CT and ERCP make for the improvement of final diagnosis rates. Radical resection is the only curative method for pancreatic duct stone complicated with pancreatic cancer.