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中国癌症防治杂志 ›› 2012, Vol. 4 ›› Issue (1): 61-64.doi: 10.3969/j.issn.1674-5671.2012.01.15

• 临床研究 • 上一篇    下一篇

胰岛素瘤的诊断与外科治疗分析(附21例报告)

  

  1. 广西医科大学第一附属医院肝胆外科
  • 出版日期:2012-03-25 发布日期:2012-04-16
  • 通讯作者: 彭涛 E-mail:pengtaocn@hotmail.com

Diagnosis and surgical treatment of insulinoma:an analysis of 21 cases

  • Online:2012-03-25 Published:2012-04-16

摘要:  目的 总结21例胰岛素瘤患者的临床特征、诊断和外科治疗经验。方法 对广西医科大学第一附属医院2006年12月至2011年10月收治并手术治疗的21例胰岛素瘤患者临床资料进行回顾性分析。结果 良性胰岛细胞瘤18例(85.7%),恶性3例(14.3%)。所有患者结合多种影像学检查(B超、CT、MRI等)均可明确定位;外科手术切除肿瘤是最有效治疗方法,恶性胰岛素瘤患者可辅助行经肝动脉化疗栓塞术;术后胰瘘和术区积液是最常见的并发症,发生率为23.8%(5/21)。结论 术前综合多种影像学检查结果可进一步明确肿瘤定位,术中超声检查可提高定位准确性。外科手术方式取决于肿瘤的位置、大小及良恶性,规范的技术操作是减少术后并发症的关键。

关键词: 胰岛素瘤, 诊断, 外科治疗

Abstract: Objective To investigate the clinical features,diagnosis and surgical treatment of a series of 21 cases of insulinoma at a single medical center.Method Clinical data for 21 patients with insulinoma treated at the First Affiliated Hospital of Guangxi Medical University between December 2006 and October 2011 were retrospectively analyzed.Result A total of 18 of the 21 cases(85.7%) were benign,and the remaining 3 were malignant(14.3%). All the tumors could be localized by ultrasound,computed tomography (CT), magnetic resonance imaging(MRI) or a combination of these techniques. Surgical resection was the best treatment, and malig-nant cases were managed by transarterial hepatic chemoembolization(TACE) in addition to surgery. The most common postoperative complication was pancreatic fistula,which occured in 5 of 21 cases(23.8%). Conclusion Preoperative imaging using multiple tech-niques can localize insulinomas,and intraoperative ultrasonography (IOUS) and surgical exploration may allow more precise localization of tumors.The optimal surgical approach depends on tumor location,size and characteristics,and should lead to minimal complications.

Key words: Insulinoma, Diagnosis, Surgical treatment