CAJ | 학술논문

目的探讨胰岛素瘤的诊断及外科治疗方法.方法回顾性分析我院收治的32例胰岛素瘤患者的临床资料,行单纯肿瘤摘除术19例,胰体、尾切除术10例,胰十二指肠切除术3例.结果 32例患者术前经腹部B超及增强螺旋CT初步诊断和定位20例,术中超声定位12例.肿瘤位于胰头部9例,胰体部15例,胰尾部8例.32例患者术后临床症状消失,包括2例胰瘘.术后病理示良性28例,恶性4例.结论胰岛素瘤的主要临床表现为典型的Whipple三联征.根据临床表现和实验室检查行术前定性诊断不难,联合影像学检查有助于提高检出率,术中探查和术中B超是定位的主要手段.手术方式需根据肿瘤部位、大小、数目及深浅等情况具体决定.
목적 탐토이도소류적진단급외과치료방법.방법 회고성분석아원수치적32례이도소류환자적림상자료,행단순종류적제술19례,이체、미절제술10례,이십이지장절제술3례.결과 32례환자술전경복부B초급증강라선CT초보진단화정위20례,술중초성정위12례.종류위우이두부9례,이체부15례,이미부8례.32례환자술후림상증상소실,포괄2례이루.술후병리시량성28례,악성4례.결론 이도소류적주요림상표현위전형적Whipple삼련정.근거림상표현화실험실검사행술전정성진단불난,연합영상학검사유조우제고검출솔,술중탐사화술중B초시정위적주요수단.수술방식수근거종류부위、대소、수목급심천등정황구체결정.
Objective To discuss the diagnosis and surgical treatment of insulinoma. Methods The clinical data of 32 patients with insulinoma were analyzed retrospectively. Of the 32 patients, 19 patients were performed with simple tumor enucleation, 10 patients with pancreatic body and tail resection, 3 patients with pancreaticoduodenectomy. Results In this study, 20 cases were diagnosed and localized the tumor by type-B abdominal ultrasonic and enhanced spiral CT before operation and 12 cases by intraoperative type-B ultrasonic. Within all patients,9 tumors located in the head of pancreas, 15 tumors in the neck , 8 tumors in the tail. The clinical symptoms in 32 cases disappeared after operation with 2 cases followed by pancreatic leakage. Of all 32 cases with insulinoma,28 tumors were diagnosed as benign and the other 4 as malignant. Conclusions The mainly clinical manifestation of insulinoma is typical whipple triad. Preoperative qualitative diagnosis is practicable according to the clinical symptom and laboratory examination. Combined imaging examinations might be helpful in improving the positive test rates. Intraoperation exploration and ultrasonography are the chief methods for the tumor localization. Site, size, number and depth of the tumor are the key points determining the surgical method style.