胰岛细胞瘤132例的诊断与外科治疗

Diagnosis and surgical treatment of functional insulinomas： report of 132 cases

目的 探讨胰岛细胞瘤的诊断及外科治疗.方法 回顾性分析解放军总医院2002年1月-2013年5月诊治的最终经病理确诊的132例胰岛细胞瘤患者的临床资料,分析该组患者临床资料之间的差异.结果 132例患者,肿瘤位于胰头部56例,胰体尾部76例.行开腹肿瘤局部切除术69例,腹腔镜肿瘤局部切除术48例,开腹胰体尾切除术5例,腹腔镜胰体尾切除术9例,胰十二指肠切除术1例.B超、CT、MRI、内镜超声、超声造影、DSA对胰岛细胞瘤检出阳性率差异有统计学意义（P＜0.01）.腹腔镜手术切除与开腹肿瘤切除相比安全性差异无统计学意义（P＞0.05）.结论 综合应用各种影像学检查可提高胰岛细胞瘤术前诊断准确性,手术切除是治愈的唯一方法,腹腔镜手术切除是治疗胰岛细胞瘤的重要方法.

Objective To investigate the diagnosis and surgical treatment of functional insulinomas.Methods One hundred and thirty two patients from January 2002 to May 2013 were retrospectively reviewed who was confirmed as functional insulinomas by pathology.Results There were 43 males and 89 females.56 cases were located in the head of pancreas,76 body and tail of pancreas.69 patients underwent open enucleation,48 patients had Laparoscopic surgery,5 patients underwent distal pancreatectomy,9 patients had Laparoscopic distal pancreatectomy,1 patients had pancreaticoduodenectomy.The difference of variant imaging examination in Checking insulinomas was statistical significant（P ＜0.01）.Laparoscopic treatment of insulinomas was at least as safe as open treatment.Conclusions Imaging examination could improve the accuracy of preoperative diagnosis of insulinomas.Surgery was the most effective methods to cure insulinomas and Laparoscopic surgery was becoming increasingly popular in treating insulinomas.