腹腔镜下胰岛素瘤切除13例

Laparoscopic resection of insulinoma:a report of 13 cases

目的探讨完全腹腔镜下胰岛素瘤手术切除的可行性、安全性。方法我科2008年1月～2012年9月住院的对13例胰岛素瘤患者行完全腹腔镜下肿瘤切除的临床资料进行回顾性分析,并总结其主要技术环节。结果 13例患者在腹腔镜超声指导下成功实施镜下胰岛素瘤切除术,其中行单纯肿瘤切除术7例,胰体尾+脾切除4例,保留脾脏胰体尾切除术2例,过程顺利,血糖监测提示手术效果满意,术后胰漏3例,保守治疗痊愈,术后无严重腹腔感染和大出血发生。随访无复发。结论腹腔镜下行胰岛素瘤切除安全、微创、可行,尤其是结合腹腔镜术中超声可有助于胰岛素瘤的的准确定位及选择合适的手术方式。

Objective To explore the feasibility and security of totally laparoscopic resection of insulinoma. Methods From January 2008 to september 2012, 13 cases of insulinoma which had laparoscopic resection were analyzed retrospectively. The main surgical technique was summarized. Results Thirteen cases of insulinomas were operated successfully guided by laparoscopic ultrasound. Amnong them, 7 cases underwent simple lumpectomy, 4 cases underwent resecton of body and tail of pancreas plus spleen and 2 cases underwent resection of body and tail of pancreas with spleen- preserving. Postoperative pancreatic leakage was found in 3 cases, which were cured by conservative treatment. The status of postoperative blood sugar was stable. There were no severe infection and massive bleeding in the abdominal cavity after operation. No recurrence was found during follow-up period. Conclusioins Laparoscopic resection of insulinoma is safe, minimally invasive and feasible. Combined with laparoscopic and intraoperative ultrasound, it would contribute to correct localization of insulinoma and choose a suitable surgical procedure.