胰岛素瘤的诊治分析(附13例报告)

Diagnosis and treatment of insulinoma:a report of 13 cases

目的总结胰岛素瘤的外科诊治经验。方法对13例胰岛素瘤患者的临床资料进行回顾性分析。结果本组患者均有典型的W h ipp le三联症表现,5例患者曾被误诊;术前B超、CT、选择性腹腔动脉造影、磁共振成像(MR I)的定位率分别为44%、50%、71%和33%;术中13例患者经触诊定位11例,2例经术中B超均获定位;术后12例治愈,1例死于复发。结论胰岛素瘤误诊率较高,必要的辅助检查有助于肿瘤的定位,手术方式的选择应根据肿瘤的部位、大小、数量而定,手术治疗效果良好。

Objective To summarize the experience of diagnosis and surgical therapy of insulinoma. Methods The clinical data of 13 patients with insulinoma from 1980 to 2004 were analyzed retrospectively. Results All patients had typical Whipple＇ s triad and 5 patients were once misdiagnosed. The preoperative accurate rates of localizing insulinoma by B - ultrasound, CT, SAG,MRI were 44% ,50% ,71% ,33% respectively. The tumors of 11 patients could be touched intraoperatively and the rest 2 cases were localized by intraoperative ultrasound. Twelve patients cured by operation and one case died of recurrence 13 months after operation. Conclusion lnsulinoma can be easily misdiagnosed. Preoperative ultrasound, CT, SAG and MRI can be selected for localization of tumor. Details of operation should be made according to the tumor location, size, number, and an effective outcome can be achieved by operation.