摘要
目的探讨功能性胰腺内分泌肿瘤的诊断和治疗方法。方法回顾性分析19例功能性胰腺内分泌肿瘤的临床资料。结果定性诊断明确胰岛素瘤15例，胃泌素瘤2例，胰高血糖素瘤2例。术前B超、CT、MRI、EUS、门静脉穿刺分段取血胰岛素测定诊断的阳性率分别为15．8％（3／19）、67．5％（10／16）、71．4％（5／7）、87．5％（7／8）及100％（2／2），术中B超的诊断阳性率85．7％（6／7）。行开放手术7例，腹腔镜手术11例，1例胰高血糖素瘤患者诊断时已出现肝转移未行手术。具体为肿瘤局部切除13例，胰体尾切除3例。胰体尾切除＋脾脏切除1例，保留十二指肠的胰头切除1例。结论血清胰岛素、胃泌素、胰高血糖素的测定是胰腺内分泌肿瘤定性诊断的主要依据。多层螺旋CT双期胰腺薄层扫描是定位诊断的主要手段，术中B超是对术前定位诊断的检验和补充。肿瘤切除是主要术式。
Objective To explore the diagnosis and management of functional pancreatic endocrine tumor. Methods Clinical data of 19 cases of functional pancreatic endocrine tumor were retrospectively analyzed. Results 15 cases of insulinoma, 2 cases of gastrinoma and 2 cases of glucagonoma were qualitatively diagnosed. The positive rate of preoperative diagosis for type B ultrasonic inspection, CT, MRI, EUS, selective portovenous sampling and intraoperative type B ultrasonic inspection was 15.8% （3/19）, 67.5% （10/16）, 71.4% （5/7）, 87.5% （7/8）, 100% （2/2） and 85.7% （6/7） respectively. Of the total 19 cases, 7 cases underwent open surgery, 11 cases underwent laparoscopic surgery, and one case didn＇t undergo any surgery as liver metastasis had occurred when glucagonoma was diagnosed. The operation methods included tumor enucleation （n=13）, distal pancreatic resection （n=3） , distal pancreatic resection plus splenectomy （n=l）, and pancreatic head resection with duodenum preserved （n=1）. Conclusions The measurement of serum insulin, gastrin and glucagon is the main basis for qualitative diagonosis of pancreatic endocrine tumor. Two stage spinal CT thin scanning is the main method for tumor location. Intraoperative type B ultrasonic inspection is the supplement to preoperative location. Tumor enucleation is the main choice of treatment.
作者
杨峻峰
周东智
顾杨阳
沙聪
袁爱军
Yang Junfertg Zhou Dongzhi Gu Yangyang Sha Cong Yuan Aijun(Department of General Suregery, Nantong Rich Hospital, Nantong 226010, China)
出处
《中华内分泌外科杂志》
CAS
2016年第6期465-467,共3页
Chinese Journal of Endocrine Surgery
关键词
胰腺内分泌肿瘤
胰腺切除术
腹腔镜手术
Functional pancreatic endocrine tumor
Pancreatic resection
Laparoscopic surgery
