24例无功能胰岛细胞瘤的诊治分析

目的总结无功能胰岛细胞瘤的外科诊治经验。方法回顾性分析24例无功能胰岛细胞瘤的临床资料。结果本组以腹部包块、腹痛、腹胀为主要首发症状。病灶主要位于胰头(62.5%)和胰尾部(20.8%)。2例为多发,均位于胰头。恶性肿瘤占45.8%,良性占54.2%,肿瘤最大径平均为6.5cm。胰体尾切除和胰十二指肠切除各占20.8%,单纯肿瘤切除占58.4%。术后主要并发症为胰瘘(16.7%)和腹腔出血(8.3%),均发生在单纯肿瘤切除的病例。良性肿瘤组中位生存期36.68个月,恶性肿瘤组的中位生存期15.67个月。结论无功能胰岛细胞瘤无特异症状;单纯肿瘤切除并发症发生率高,需行肿瘤所在部位的胰腺区域切除。

The diagnosis and surgical treatment of nonfunctional pancreatic islet cell tumors in 24 cases

Objective To review the experience on the diagnosis and surgical treatment of nonfunctional pancreatic islet cell tumors. MethodsWe analyzed retrospectively 24 cases of nonfunctional pancreatic islet cell tumors. ResultsThere were 13 males and 11 females. The main symptoms included abdominal mass, bellyache, abdominal distention. Tumors mainly located in pancreatic head (62.5%) and tail (20.8%), two cases were of multiple foci, all within pancreatic head. Tumors were malignant in 45.8% and benign in 54.2%. Average tumor diameter was 6.5 cm. Pancreatic body-tail resection was performed in 20.8% of cases, pancreaticoduodenectomy was performed in 20.8% of cases, simple tumor resection was performed in the other 58.4%. Main complications were pancreatic leak (4 cases) and intraabdominal bleeding (2 cases), all occured in simple tumor resection group. The median survival of benign and malignant tumor were 36.68 months and 15.67 months respectively. ConclusionsThere is no specific symptom for nonfunctional pancreatic islet cell tumors, simple tumor resection has a high complication rate; regional pancreas resection is recommended for nonfunctional pancreatic islet cell tumors.