全腹腔镜下胰岛素瘤切除术18例单中心经验总结

Laparoscopic insulinoma resection:the experiences of 18 cases in one center

目的:总结全腹腔镜下胰岛素瘤的诊断和治疗经验。方法:回顾分析2002年6月至2009年10月北京协和医院为18例患者施行全腹腔镜下胰岛素瘤切除术的临床资料,分析全腹腔镜胰岛素瘤切除术的安全性、可行性及主要技术环节。结果:18例中1例胰岛素瘤位于胰颈外,余均位于胰体/尾部,肿瘤直径平均(1.77±0.57)cm;7例行肿瘤切除术,7例行保留脾脏的胰腺远端切除术,4例中转开腹,中转开腹率22.2%。术后平均随访48个月,无低血糖症状复发。结论:全腹腔镜胰岛素瘤切除术安全可行,尤其肿瘤位于胰头表面或胰体尾部,更优于经典的开腹手术。

Objective：To share the diagnostic and therapeutic experiences in laparoscopic pancreatic insulinoma resection.Methods：Eighteen patients with insulinoma were admitted and performed laparoscopic resection of insulinoma in Peking Union Medical College Hospital from Jun.2002 to Oct.2009.Safety,feasibility and the crucial technical manipulations was analyzed retrospectively.Results：All patients were located at the body or tail of pancreas except 1 case of pancreatic neck insulinoma preoperatively by EUS,abdominal CT and digital subtraction angiography（DSA）.The median size of tumor was（1.77±0.57）cm.Enucleation was performed in 7 of 18 cases of insulinoma,while distal pancreatectomy with spleen preservation was performed in another 7 cases.4 patients were converted to open resection,and the conversion rate was 22.2%.The median time of follow up was 48 months,with no hypoglycemic symptoms recurred.Conclusions：Total laparoscopic resection of pancreatic insulinoma is safe and feasible.Especially tumor location is on the surface of pancreatic head,in the body or tail of the pancreas,its application has more advantages in comparison with conventional open surgery.