【摘要】 目的　评价胰岛素瘤的各种定位诊断方法的阳性率和各种手术治疗方法。方法　回顾性地分析我院自 1978年 1月至 1998年 12月诊治的胰岛素瘤 41例。结果　术前B型超声、CT定位诊断阳性率分别为 41% (15 / 34 )和 48% (12 / 2 5 ) ,手术探查的阳性发现率为 92 % (36 / 39)、术中超声为 10 0 % (9/ 9)。肿瘤局部摘除术 2 0例 ,远段胰腺切除术 18例。结论　胰岛素瘤的术前定位诊断较为困难 ,手术探查和术中超声检查是定位诊断的最佳方法。胰岛素瘤行肿瘤摘除术的术后并发症发生率较低 ,是治疗良性胰岛素瘤的最佳方式 ;多发性胰岛素瘤或合并MENⅠ的胰岛素瘤应行胰腺次全切除术以避免复发。更多还原

【Abstract】 Objective[WT5”BZ] To evaluate methods used for locating diagnosis and surgical treatment of insulinoma.[WT5”HZ] Method[WT5”BZ] Results of locating tumor foci were retrospectively analyzed in 41 cases with insulinomas in our hospital from Jan. 1978 to Dec. 1998.[WT5”HZ]Results[WT5”BZ] The sensitivity of ultrasonography (US) was 41 1%(15/34), computed tomography (CT) 48% (12/25),superselective angiography 84 6%,intraoperative palpation 92 3%(36/39) and intraoperative ultrasonography (IOUS) revealed tumors in 100%(9/9) of cases.Surgical enucleation were performed in 20 cases and distal pancreatectemy in 18 cases.[WT5”HZ] Conclusions[WT5”BZ] Perioperative accurate location of the tumor is one of the most important factors in the management of insulinomas.The locating diagnosis of insulinomas was achieved mainly by a combination of selective angiography,intraoperative ultrasonography(IOUS) and intraoperative palpation.Enucleation when possible is the best choice for benign insulinomas and gives the lowest complication rate. In patients with MENⅠ,subtotal pancreatectomy with enucleation of tumors from the pancreatic head and uncinate process is recommended over simple enucleation because of frequent multiple tumors. [WT5”HZ]更多还原