摘要
目的探讨胰岛细胞瘤的诊断及外科治疗。方法回顾分析近3年我院手术治疗8例胰岛细胞瘤的经验,总结胰岛细胞瘤临床特征、诊治方法及其效果。结果本组8例病例中,无功能性胰岛细胞瘤1例,胰岛素瘤7例。肿瘤位于胰头3例,胰体3例,胰尾2例。术前螺旋CT明确肿瘤定位7例(88%),B超明确肿瘤定位4例(50%)。术前行经动脉钙剂刺激肝静脉取血测定胰岛素(ASVS)检查5例,明确肿瘤定位5例(100%)。所有病例行术中超声和触摸探查,明确定位8例(100%)。行单纯肿瘤切除术4例,胰腺中段切除+胰空肠吻合术1例,钩突切除术1例,保留脾脏胰体尾切除术2例。术后胰瘘发生率为25%(2/8),无手术死亡病例。结论对良性胰岛细胞瘤,单纯肿瘤切除或胰腺部分切除疗效肯定。胰岛素瘤仍有较高误诊率,多排螺旋CT可作为术前定位首选,建议常规行术中超声联合触诊,ASVS可能对复杂病例更有意义。
Objective To discuss the diagnosis and treatment of islet cell tumor.Methods Eight patients with islet cell tumor in recent 3 years were analyzed retrospectively.The clinical characteristics and the therapeutic outcomes of them were summarized.Results Of the 8 patients,1 patient was nonfunctional islet cell tumor and the remaining 7 patients were insulinomas.The tumors were located in the head of pancreas in 3 cases,in the body of pancreas in 3 cases,and in the tail of pancreas in 2 cases.The sensitivity of B-US,Mutislice CT,ASVS,combined intra-operation ultrasound and palpation were 50%（4/8）,88%（7/8）,100%（5/5）,100%（8/8）respectively.Local excision was performed in 4 patients,spleen preserving distal pancreatectomy in 2 patients,medial pancreatectomy in 1 patient,and resection of uncinate process of pancreas in 1 case.Pancreatic leakage occurred in 2 cases（25%）.There was no postoperative mortality.Conclusion Local excision or partial pancreas resection for pancreatic islet cell tumor is enough for benign ones.Misdiagnosis rate of insulinoma is still high,Mutislice CT can be adopted as the fist choice for localizing tumors before operation,Combined intra-operative ultrasound and palpation is recommended to be a routine method during operation,ASVS may be more suitable for complicated cases.
出处
《新疆医科大学学报》
CAS
2010年第3期292-294,共3页
Journal of Xinjiang Medical University
