【摘要】 目的探讨无功能胰岛细胞瘤的临床特点和诊断治疗方法。方法回顾性分析23例无功能胰岛细胞瘤的临床资料。结果以腹部肿块(65.2%),腹痛腹胀(47.8%),梗阻性黄疸(26.1%)等为主要临床表现;经B超,CT,MRI等影像学检查均诊断为胰腺肿瘤,肿瘤平均直径为9.5cm。行胰十二指肠切除11例(47.8%),胰体尾切除+脾切除术5例(21.7%),其他7例(30.4%)。术后病理证实20例为良性(87.0%),3例为恶性(13.0%)。胰瘘(3例,13.0%)是主要的术后并发症,均经非手术方法治愈。随访恶性者3例中1例术后1年内死亡,另2例现已无瘤生存29个月和8个月;随访17例良性者,已分别生存1～7年。结论无功能胰岛细胞瘤的诊断应根据临床表现、实验室和影像学检查并结合术中的探查、术后病理综合确定,手术治疗预后良好。更多还原

【Abstract】 Objective To investigate the clinical features,diagnosis and treatment of nonfunctioning islet cell tumors(NFIT).Methods The clinical data of 23 patients with NFIT,who were admitted to our hospital from Jan.2002 to Dec.2008,were retrospectively studied.Results The main clinical manifestations of NFIT included abdominal mass,abdominal pain and distension and obstructive jaundice.The diagnoses of pancreatic tumors were confirmed by imaging studies including ultrasonography,CT and MRI.The average diameterof the tumors was 9.5cm.Pancreaticoduodenectomy was performed in 47.8%(11/23),resection of pancreatic body and tail together with spleen was performed in 21.7%(5/23),and other procedures were performed in 31.5%(7/23) of patients.Tumors were malignant in 13.0%(3/23) and benign in 87.0%(20/23) according to postoperative pathology.The major postoperative complication was pancreatic fistula(13.0%),and it healed by nonoperative therapies in all of the cases.One of 3 patients with malignantNFIT died within 1 year after operation,while the other 2 had survived,without tumor recurrence,for 29 months and 8 months respectively on follow-up.Seventeen patients with benign NFIT had survived for 1 to 7 years on follow-up.Conclusions The diagnosis of NFIT should be based on clinical manifestations,lab data,imaging study findings,intraoperative exploration and postoperative pathology.The prognosis of surgicaltreatment is good.更多还原