目的 正确评价胰岛素瘤的各种定位诊断方法和各种手术治疗方法。
方法 回顾性分析吉林大学第一医院普外科与吉林省肿瘤医院普外科1985年6月至2005年6月期间诊治的38例胰岛素瘤的临床资料，系统评价术前超声、术中超声、术前CT及术前增强CT定位诊断方法。
结果 术前超声、术前CT、术前增强CT及术中超声检查其确诊率分别为47.4%、51.5%、85.7%及100%。行肿瘤局部摘除术21例，单纯远端胰腺切除术14例，远端胰腺切除术联合脾摘除3例。
结论 胰岛素瘤的术前定位诊断较困难，术前超声与术前CT在术前定位诊断方面差异无统计学意义，术前增强CT能够明显提高胰岛素瘤的术前诊断率，术中超声是胰岛素瘤最有效的定位诊断方法。行肿瘤摘除术是治疗良性胰岛素瘤的最佳方式，能够降低术后并发症发生率。多发性胰岛素瘤或恶性胰岛素瘤应行胰腺次全切除术以避免复发，必要时可联合脾脏摘除。
Citation：
王磊,周亚男,张文良,魏丰,纪柏,孙希光,王广义,谭毓铨. Location Diagnosis and Treatment of Insulinoma (Report of 38 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(2): 214-215. doi:
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- 1. Anderson MA, Carpenter S, Thompson NW, et al. Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas [Ｊ]. Am J Gastroenterol， 2000; 95(9)∶2271.
- 2. Machado MC, da Cunha JE, Jukemura J, et al. Insulinoma: diagnostic strategies and surgical treatment. A 22-year experience [Ｊ]. Hepatogastroenterology, 2001; 48(39)∶854.
- 3. Guo KJ, Liao HH, Tian YL, et al. Surgical treatment of nonfunctioning islet cell tumor: report of 41 cases [Ｊ]. Hepatobiliary Pancreat Dis Int, 2004; 3(3)∶469.
- 4. Assalia A, Gagner M. Laparoscopic pancreatic surgery for islet cell tumors of the pancreas [Ｊ]. World J Surg, 2004; 28(12)∶1239.
- 5. Ikenaga N, Yamaguchi K, Konomi H, et al. A minute nonfunctioning islet cell tumor demonstrating malignant features [Ｊ]. J Hepatobiliary Pancreat Surg, 2005; 12(1)∶84.
