胰岛素瘤的诊断与治疗（附22例报告）

The diagnosis and treatment of insulinoma.

目的 探讨胰岛素瘤的诊断及外科治疗方法。方法 回顾性分析22例胰岛素瘤患者的临床资料。结果 术前B超、CT、MRI和选择性动脉造影检查的阳性率分别为20％（3／15）、38．5％（5／13）、42．9％（3／7）、66．7％（4／6），术中B超检查的阳性率为100％（15／15）。22例中行肿瘤摘除术14例，胰体尾切除术8例。结论 胰岛素瘤的术前定位诊断比较困难，术中B超检查准确性很高；外科手术是胰岛素瘤惟一可靠的治疗方法，肿瘤摘除为主要术式。

Objective To study the diagnosis and treatment of insulinoma. Methods The clinical data of 22 cases of insulinoma were reviewed retrospecively. Results The positive rates in detection of insulinoma by preoperative uhrasonography,CT scan,MRI and selected arteriography were 20% （ 3/15） ,38.5 % （ 5/13） ,42.9% （ 3/ 7 ） and 66.7% （4/6 ） respectively. The positive rate of intraoperative ultrasonography was 100 % （ 15/15 ）. Enucleation was conducted in 14 cases and distal pancreatectomy was performed in 8 cases. Conclusion The preoperative diagnosis of insulinoma is comparatively difficult. Intraoperative ul trasonography can get high accuracy. The resection of the tumors is the only reliable treatment to insul inoma. Simple enucleation is the main surgical procedure.