胰岛素瘤的诊断与治疗

Diagnosis and treatment of pancreatic insulinomas

目的 总结胰岛素瘤的诊断和治疗经验。方法 回顾性分析本院 1981年 1月～ 2 0 0 3年 12月经手术治疗、病理证实的2 2例胰岛素瘤病人的临床诊断、治疗与愈后。结果 多发性胰岛素瘤占 13.6 % ,恶性胰岛素瘤占 13.6 % ,盲目胰体尾部切除可导致手术失败 ,多发性胰岛素瘤术后可复发 ,近年来 5例病人术中B超检查均发现肿瘤病灶。结论 术中超声、监测血糖 ,警惕多发性病灶是评估肿瘤是否切除完全的重要手段 ,根据肿瘤大小、部位及冰冻结果是确定手术方案的重要依据。

Objective To summerize our experience in the diagnosis and treatment of pancreatic insulinomas.Methods Twenty-two patients of pancreatic insulinoma from Jan.1981 to Dec.2003 in our hospital confirmed by surgery and pathology were retrospectively reviewed.Results There were three cases (13.6%) of multiple insulinomas,and three cases of malignant insulinomas.One case of blind distal pancreatectomy caused failure of resecting tumor.One patient with multiple insulinomas had recurrence four years postoperation.Intraoperative ultrasound could accurately localize all tumors in five patients .Conclusion ntraoperative ultrasound scan ,monitoring blood glucose values and aware of multiple insulinomas are the most important points for evaluation of completely tumor resection .Details of operation should be made according to the tumor size, location,and freezing pathologic diagnosis.