摘要
目的 总结胰岛素瘤的诊治经验,评估胰岛素瘤的多种定位诊断技术。方法 回顾性分析两院1970年～2001年来收治的62例胰岛素瘤的临床资料。结果 CT、MRI、术前B超、SAOG及IOUS诊断胰岛素瘤的敏感性分别为46.4％、70.0％、75.6％、75.9％和100％;手术治疗60例,其中实施肿瘤剜除术41例,胰体尾切除术14例,胰十二指肠切除术3例,楔形切除术1例,姑息手术1例,总手术切除率98.3％;全组无手术死亡,肿瘤切除术后病人随访无低血糖发作;术后并发症包括胰瘘5例、胰腺假性囊肿2例。结论 术前B超和SAOG、术中详尽扪诊联合IOUS可基本上取得胰岛素瘤较为满意的定位诊断;根据胰岛素瘤的大小、部位、数目及性质采取适宜的手术方式是获得良好疗效的关键。
Objective To summarize the experience in diagnosis and treatment of insulinomas and to evaluate the sensitivity of various modalities for preoperative and intraoperative tumor localization. Methods The clinical data of 62 patients with insulinomas or hyperplasia of pancreas were retrospectively analyzed. Results The sensitivity of tumor localization with computed tomography (CT), magnetic resonance imaging (MRI), preoperative ultrasonography (US), selective angiography (SAOG), and intraoperative ultrasonography (IOUS) was 46. 4%, 70. 0%, 75. 6%, 75. 9% and 100%, respectively. 59 patients with insulinomas underwent radical resection, including enucleation of tumor in 41 cases, resection of distal pancreas in 14 cases, and pancreaticoduodenectomy in 3 cases, and wedge resection in one case. The overall resection rate was 98. 3%. All cases of insulinomas were cured after resection, and 5 cases were complicated with pancreatic fistulae and 2 cases with pancreatic pseudocyst. Four patients took a favorable turn after active drainage. Conclusions The topographic diagnosis by a combination of preoperative US, SAOG, intraoperative palpation and IOUS for insulinoma is essential for selection of surgical treatment modalities and successful therapeutic efficacy.
出处
《胰腺病学》
2002年第3期133-135,共3页
Chinese JOurnal of Pancreatology
