中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2014年
3期
193-196
,共4页
胰岛素瘤%诊断%手术治疗
胰島素瘤%診斷%手術治療
이도소류%진단%수술치료
Insulinoma%Diagnosis%Surgical treatment
目的 总结胰岛素瘤的诊治经验.方法 回顾分析1966年至2008年收治的130例胰岛素瘤的临床资料.结果 本组130例均有Whipple三联征表现,平均病程5.17年.37.7％的患者曾被误诊,仅43.8％患者在发病1年内得到正确诊断.术前超声、CT、MRI和ASVS的正确定位率分别为32.9％、70.6％、70.3％和88.9％.其中单发胰岛素瘤121例(93.1％),多发胰岛素瘤4例(3.1％),增生5例(3.8％);良性病变127例(97.7％),恶性胰岛素瘤3例(2.3％).130例均行手术治疗,其中行胰岛素瘤摘除术89例.术后胰瘘发生率为19.2％,胰腺炎发生率为3.9％.结论 Whipple三联征具有定性诊断意义,胰腺薄层三期增强扫描仍是目前胰岛素瘤术前定位诊断的首选方法,ASVS则可作为常规影像学定位阴性的补充定位手段.手术摘除是目前最主要的治疗手段.
目的 總結胰島素瘤的診治經驗.方法 迴顧分析1966年至2008年收治的130例胰島素瘤的臨床資料.結果 本組130例均有Whipple三聯徵錶現,平均病程5.17年.37.7％的患者曾被誤診,僅43.8％患者在髮病1年內得到正確診斷.術前超聲、CT、MRI和ASVS的正確定位率分彆為32.9％、70.6％、70.3％和88.9％.其中單髮胰島素瘤121例(93.1％),多髮胰島素瘤4例(3.1％),增生5例(3.8％);良性病變127例(97.7％),噁性胰島素瘤3例(2.3％).130例均行手術治療,其中行胰島素瘤摘除術89例.術後胰瘺髮生率為19.2％,胰腺炎髮生率為3.9％.結論 Whipple三聯徵具有定性診斷意義,胰腺薄層三期增彊掃描仍是目前胰島素瘤術前定位診斷的首選方法,ASVS則可作為常規影像學定位陰性的補充定位手段.手術摘除是目前最主要的治療手段.
목적 총결이도소류적진치경험.방법 회고분석1966년지2008년수치적130례이도소류적림상자료.결과 본조130례균유Whipple삼련정표현,평균병정5.17년.37.7％적환자증피오진,부43.8％환자재발병1년내득도정학진단.술전초성、CT、MRI화ASVS적정학정위솔분별위32.9％、70.6％、70.3％화88.9％.기중단발이도소류121례(93.1％),다발이도소류4례(3.1％),증생5례(3.8％);량성병변127례(97.7％),악성이도소류3례(2.3％).130례균행수술치료,기중행이도소류적제술89례.술후이루발생솔위19.2％,이선염발생솔위3.9％.결론 Whipple삼련정구유정성진단의의,이선박층삼기증강소묘잉시목전이도소류술전정위진단적수선방법,ASVS칙가작위상규영상학정위음성적보충정위수단.수술적제시목전최주요적치료수단.
Objective To summarize the diagnosis and surgical therapeutic experience of insulinoma.Methods The clinical data of 130 patients with insulinoma confirmed by pathologic examination from 1966 to 2008 were analyzed retrospectively.Results All the patients had Whipple's triad.37.7％ were once misdiagnosed.Only 43.8 ％ were diagnosed correctly within one year after the onset of symptoms.The average time of evolution was 5.2 years.Ultrasonography,CT,MRI and ASVS were able to localize tumor in 32.9％,70.6％,70.3％ and 88.9％ of the cases,respectively.There were 121 cases (93.1％) of single insulinoma,4 cases (3.1％)of multiple insulinomas,and 5 cases(3.8％)of hyperplasia.127cases(97.7 ％)were benign and 3 cases (2.3 ％)were malignant insulinoma.All the 130 cases underwent surgery,among whom 89 cases were cured by enucleation of tumor.The principal postoperative complications were pancreatic fistula(19.2％) and pancreatitis(3.9％).Conclusions Whipple's triad was with great significance to diagnose insulinoma.Multislice spiral CT is the first choice for preoperative localization of insulinoma and ASVS is an important complementary measure for localizing insulinomas not detected by CT or MRI.Simple enucleation is the most common surgical method.
