胰岛素瘤的诊治进展

The progress in diagnosis and treatment of insulinoma

胰岛素瘤来源于胰岛β细胞,是最常见的胰腺内分泌肿瘤。根据典型的Whipple三联症和生化指标,胰岛素瘤的定性诊断并不困难,但定位诊断仍是临床难点。定位诊断优先考虑螺旋CT、胰腺灌注及内镜超声等新技术。目前,手术切除是根治胰岛素瘤的唯一有效手段。手术方式的选择,良性胰岛素瘤可选择腹腔镜剜除术,对肿块较大或具有潜在恶性胰岛素瘤仍以开腹手术为宜,失去手术机会的恶性胰岛素瘤则选择药物治疗。本文着重对该病的定性诊断、定位诊断,腹腔镜剜除术、开腹手术以及药物治疗做简要概述。

Insulinoma,derives from beta cells,which is one of the most common pancreatic endocrine tumors.According to the typical whipple＇s triad and biochemical indicators,the qualitative diagnosis of insulinoma is not difficult,but the localization diagnosis is still a challenge.The spiral computed tomography,pancreatic perfusion and endoscopic uhrasonography are the preferred technologys for the localization diagnosis.Currently,surgical treatment is still the only curative method.Laparoscopic resection for benign insulinomas is the procedure of choice.Laparotomy is still reserved for large or potentially malignant tumors,and we can choose pharmacotherapy for the unresectable malignant insulinoma.This review aimed to summarize the qualitative and located diagnosis,laparoscopic resection,laparotomy and pharmacotherapy of insulinoma.