【摘要】 目的 总结胰岛素瘤的临床特点和诊治经验,并讨论其诊治方法。方法 回顾性分析了1997年1月至2012年1月间收治的32例胰岛素瘤的临床表现和辅助检查等特点,并结合文献讨论胰岛素瘤诊治的有关问题。结果 32例患者均有Whipple三联征,术前B超、CT、数字减影血管造影(DSA)定性诊断的准确率分别为28.1%(9/32)、64.0%(16/25)、90.0%(9/10),术中B超为100%(9/9)。肿瘤局部摘除术20例,胰体尾切除术7例(加做脾切除3例),胰尾切除术4例,原发性肝癌并胰腺部分切除术1例。结论 准确的术前定位及定性检查有助于术中选择合理的手术方式,术中超声是胰岛素瘤最有效的定位诊断方法。胰岛素瘤一经确诊,须尽快手术治疗。行肿瘤摘除术是治疗良性胰岛素瘤的最佳方式,能够降低术后并发症发生率。更多还原

【Abstract】 Objective To explore the diagnosis and treatment of insulinoma and summarize its clinical characteristics.Methods The clinical,surgical and pathologic features for 32 cases of insulinoma at our hospital from January 1997 to January 2012 were retrospectively analyzed.Results Each had typical Whipple’s triad.The diagnostic accuracy of ultrasonography,computed tomography,digital subtraction angiography and intraoperative ultrasonography was 28.1%(9/32),64.0%(16/25),90.0%(9/10) and 100%(9/9) respectively.The procedures included enucleation(n = 20),resection of pancreatic body & tail(n = 7)(splenectomy in 3),resection of pancreatic tail(n = 4) and resection of hepatocellular carcinoma and partial pancreas(n= 1).Conclusions Accurate preoperative localization and qualitative examination may help to select an optimal surgical approach.Intraoperative ultrasound is the most effective modality of locating insulinoma.Definite insulinoma should be resected as soon as possible.And enucleation is the best method of reducing the incidence of postoperative complications.更多还原