胰腺分段血运阻断法行胰岛素瘤术中定位——附6例报告

Clinical study of intraoperative localization of insulinoma by using step-by-step occlusion of the pancreas

目的 探讨胰腺分段血运阻断法在胰岛素瘤手术中的定位作用。方法 对6例胰岛素瘤进行11例次胰腺部分血运阻断,分析每次血运阻断前后血糖水平的变化,对胰岛素瘤的位置进行判断。结果 当胰岛素瘤位于阻断范围内时,血糖快速上升;当胰岛素瘤位于阻断范围外时,血糖无变化;当胰岛素瘤位于阻断处时,血糖快速下降。结论 胰腺分段血运阻断法对手术中胰岛素瘤的定位具有重要的指导意义,既可避免多发性肿瘤时的残留、胰腺组织的盲目切除和胰腺切除量的不足,又不增加手术风险。

Objective To validate clinical efficacy of intraoperative localization of insulinoma by using step-by-step occlusion of the pancreas. Methods Step-by-step occlusion of the pancreas was attempted 11 times in six cases of insulinoma, and changes in blood glucose before and after occlusion were observed whereby the location of insulinoma was assessed. Results Blood glucose rose rapidly when the insulinoma was located within the scope of occlusion; blood glucose remianed unchanged when the insulinoma was beyond the scope of occlusion, and blood glucose dropped swiftly when the insulinoma was on the point of occlusion. Conclusions The technique of step-by-step occlusion of the pancreas is of directive significance in intraoperative localization of insulinoma. It takes less operative risk, and can avoid multi-tumor residues, blind or insufficient resction of the pancreatic tissue.