BACKGROUND: Nonfunctioning islet cell tumor (NIT)as a rare pancreatic endocrine neoplasm is characterized byunspecific clinical symptoms and is hard to diagnose. InChina, NIT accounts for 15%-41% in pancreatic endocri...BACKGROUND: Nonfunctioning islet cell tumor (NIT)as a rare pancreatic endocrine neoplasm is characterized byunspecific clinical symptoms and is hard to diagnose. InChina, NIT accounts for 15%-41% in pancreatic endocrineneoplasms just next to insulinoma. In this study, weevaluated the surgical modalities of NIT.METHODS: From January 1978 through February 2002, 41patients with NIT were treated at the Department of Sur-gery of the First Affiliated Hospital, China Medical Univer-sity, Shenyang, China. Tumors in the head of the pancreaswere noted in 28 patients, and in the body or in the tail in13 patients. The mean diameter of the tumors was 10. 7cm. Fifteen patients underwent enucleation and 21 receivedpancreatectomy. Tumors were unresectable in 5 patientsbecause of extensive infiltration. The mean diameter was9.6 cm in patients treated by enucleation, 13.1 cm in thoseby pancreaticoduodenectomy, 9.9 cm in those by distalpancreatectomy, and 11.6 cm in those with unresectabletumors.RESULTS: The curative resection rate was 88% (n =36),and the complication rate after enucleation and pancreatec-tomy was 33% ( n = 5 ) and 14% (n=3), respectively. Nolocal recurrence was found after both enucleation and pan-createctomy. Liver metastases occurred in 3 patients treatedby enucleation.CONCLUSIONS: Both enucleation and pancreatectomy areeffective for NIT of the pancreas. No local recurrence hasbeen found in patients treated by the two surgical proce-dures. The complication rates of the two modalities arecomparable.展开更多
AIM:To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.METHODS: We retrospectively analyzed 20 patients who underwent CR at the Second...AIM:To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.METHODS: We retrospectively analyzed 20 patients who underwent CR at the Second Affi liated Hospital of Zhejiang University School of Medicine between April 2000 and October 2008. For pancreaticojejunostomy, a modified invagination method, continuous circular invaginated pancreaticojejunostomy (CCI-PJ) was used. Modified continuous closed lavage (MCCL) was performed for patients with pancreatic fistula.RESULTS: The indications were: serous cystadenomas in eight patients, insulinomas in six, non-functional islet cell tumors in three and solid pseudopapillary tumors in three. Perioperative mortality was zero and morbidity was 25%. Overall, pancreatic fistula was present in 25% of patients. At a mean follow up of 42.7 mo, all patients were alive with no recurrence and no new-onset diabetes mellitus or exocrine dysfunction.CONCLUSION: CR is a safe and effective procedure for patients with benign tumors in the proximal pancreas, with careful CCI-PJ and postoperative MCCL.展开更多
目的探讨胰岛细胞瘤的临床特点、诊治方法及转归。方法回顾性分析2000年1月—2013年4月北京大学第一医院收治的18例胰岛细胞瘤患者的临床特点、诊断和治疗方法、转归等资料。结果 18例患者中,男女比为1∶2;年龄为18~83岁,中位年龄51岁...目的探讨胰岛细胞瘤的临床特点、诊治方法及转归。方法回顾性分析2000年1月—2013年4月北京大学第一医院收治的18例胰岛细胞瘤患者的临床特点、诊断和治疗方法、转归等资料。结果 18例患者中,男女比为1∶2;年龄为18~83岁,中位年龄51岁。16例为功能性胰岛细胞瘤,2例为无功能性胰岛细胞瘤,功能性胰岛细胞瘤均为胰岛素瘤,其中2例合并糖尿病。胰岛素瘤患者临床上均有典型的Whipple三联征;血糖为0.85~2.56mmol/L,同时胰岛素水平>10 m U/L有16例,胰岛素释放指数>0.4有11例,胰岛素释放修正指数>100有14例。胰岛素瘤患者行B超检查11例,5例阳性;行增强CT检查14例,11例阳性。行B超、CT检查均阴性的3例患者分别经胃镜超声、经皮经肝门静脉置管分段采血测定胰岛素(PTPC)、剖腹探查术中B超及分段采血方法进行诊断。17例胰岛细胞瘤患者行手术治疗,其中行肿瘤局部切除术10例,胰腺体尾部切除术6例,Whipple术式1例。患者术后均未出现严重并发症,胰岛素瘤患者术后低血糖均恢复。结论胰岛细胞瘤以功能性胰岛素瘤居多,少数合并糖尿病,确诊需有典型的Whipple三联征、胰岛素水平测定及胰岛素释放指数定性诊断,增强CT定位检查阳性率高。胰岛细胞瘤良性率高,治疗以外科手术为主。展开更多
文摘BACKGROUND: Nonfunctioning islet cell tumor (NIT)as a rare pancreatic endocrine neoplasm is characterized byunspecific clinical symptoms and is hard to diagnose. InChina, NIT accounts for 15%-41% in pancreatic endocrineneoplasms just next to insulinoma. In this study, weevaluated the surgical modalities of NIT.METHODS: From January 1978 through February 2002, 41patients with NIT were treated at the Department of Sur-gery of the First Affiliated Hospital, China Medical Univer-sity, Shenyang, China. Tumors in the head of the pancreaswere noted in 28 patients, and in the body or in the tail in13 patients. The mean diameter of the tumors was 10. 7cm. Fifteen patients underwent enucleation and 21 receivedpancreatectomy. Tumors were unresectable in 5 patientsbecause of extensive infiltration. The mean diameter was9.6 cm in patients treated by enucleation, 13.1 cm in thoseby pancreaticoduodenectomy, 9.9 cm in those by distalpancreatectomy, and 11.6 cm in those with unresectabletumors.RESULTS: The curative resection rate was 88% (n =36),and the complication rate after enucleation and pancreatec-tomy was 33% ( n = 5 ) and 14% (n=3), respectively. Nolocal recurrence was found after both enucleation and pan-createctomy. Liver metastases occurred in 3 patients treatedby enucleation.CONCLUSIONS: Both enucleation and pancreatectomy areeffective for NIT of the pancreas. No local recurrence hasbeen found in patients treated by the two surgical proce-dures. The complication rates of the two modalities arecomparable.
文摘AIM:To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.METHODS: We retrospectively analyzed 20 patients who underwent CR at the Second Affi liated Hospital of Zhejiang University School of Medicine between April 2000 and October 2008. For pancreaticojejunostomy, a modified invagination method, continuous circular invaginated pancreaticojejunostomy (CCI-PJ) was used. Modified continuous closed lavage (MCCL) was performed for patients with pancreatic fistula.RESULTS: The indications were: serous cystadenomas in eight patients, insulinomas in six, non-functional islet cell tumors in three and solid pseudopapillary tumors in three. Perioperative mortality was zero and morbidity was 25%. Overall, pancreatic fistula was present in 25% of patients. At a mean follow up of 42.7 mo, all patients were alive with no recurrence and no new-onset diabetes mellitus or exocrine dysfunction.CONCLUSION: CR is a safe and effective procedure for patients with benign tumors in the proximal pancreas, with careful CCI-PJ and postoperative MCCL.
文摘目的探讨胰岛细胞瘤的临床特点、诊治方法及转归。方法回顾性分析2000年1月—2013年4月北京大学第一医院收治的18例胰岛细胞瘤患者的临床特点、诊断和治疗方法、转归等资料。结果 18例患者中,男女比为1∶2;年龄为18~83岁,中位年龄51岁。16例为功能性胰岛细胞瘤,2例为无功能性胰岛细胞瘤,功能性胰岛细胞瘤均为胰岛素瘤,其中2例合并糖尿病。胰岛素瘤患者临床上均有典型的Whipple三联征;血糖为0.85~2.56mmol/L,同时胰岛素水平>10 m U/L有16例,胰岛素释放指数>0.4有11例,胰岛素释放修正指数>100有14例。胰岛素瘤患者行B超检查11例,5例阳性;行增强CT检查14例,11例阳性。行B超、CT检查均阴性的3例患者分别经胃镜超声、经皮经肝门静脉置管分段采血测定胰岛素(PTPC)、剖腹探查术中B超及分段采血方法进行诊断。17例胰岛细胞瘤患者行手术治疗,其中行肿瘤局部切除术10例,胰腺体尾部切除术6例,Whipple术式1例。患者术后均未出现严重并发症,胰岛素瘤患者术后低血糖均恢复。结论胰岛细胞瘤以功能性胰岛素瘤居多,少数合并糖尿病,确诊需有典型的Whipple三联征、胰岛素水平测定及胰岛素释放指数定性诊断,增强CT定位检查阳性率高。胰岛细胞瘤良性率高,治疗以外科手术为主。
