胰岛细胞瘤25例外科诊治分析

目的探讨胰岛细胞瘤的临床诊断和外科治疗方法。方法对某院2001.1~2010.12收治的胰岛细胞瘤25例患者的临床资料进行回顾,结合相关文献进行诊治分析。结果 25例患者中,非功能性胰岛细胞瘤12例,功能性胰岛细胞瘤13例。肿瘤位于胰头7例,胰颈4例,胰体尾14例。肿瘤直径0.5~20cm。13例功能性胰岛细胞瘤均有Whipple三联征。全部病例术前均行B超和/或CT检查,7例术前行DSA检查。25例患者均行手术治疗,单纯肿瘤切除16例,胰体尾部切除5例,胰体尾切除加脾切除2例,胰颈部切除1例,瘤灶切除后十二指肠修补+旷置+胰头-十二指肠空肠壁吻合1例。术后发生胰漏1例。全部患者治愈出院。结论 NIT无特异临床表现,但影像学检查能较有效检出。FIT临床主要表现为典型的Whipple三联征。CT和DSA是有效的术前定位方法。手术切除是胰岛细胞瘤治疗的最佳选择。

Analysis of dlagnosis and surgical treatment of islet cell tumor in 25 cases

OBJECTIVE To investigate the clinical diagnosis and surgical treatment of islet cell tumor.METHODS Combining with related literatures,the clinical data of 25 cases of islet cell tumors treated in our hospital during January 2001 to December 2010 were retrospectively analyzed.RESULTS Of all the 25 cases,12 patients with non-functionality islet cell tumor(NIT),13 patients with functionality islet cell tumor,The tumors were localized in the head,neck,body and tail of pancreas in 7,4,and 14 cases respectively.Tumors were with a diameter of 0.5-20cm.There were typical Whipple triad in all the patients with islet cell tumor,all patients underwent B-mode ultrasonography and/or CT examination,7 cases underwent DSA(digital subtraction angiography)examination.All patients underwent operation,including local excision in 16 cases,the body and tail of pancreas resection in 5 cases,distal pancreatectomy with splenectomy in 2 cases,pancreatic neck resection in 1 case,enucleation of tumor and pancreatico-duodenojejunostomy in 1 case.1 case was with postoperative pancreatic fistula.All patients were cured and discharged.CONCLUSION NIT has no specific clinical manifestation,but can be effectively detected by imaging examinations.Whipple triad is the most typical manifestation of insulinoma.CT and DSA are effective methods for preoperative location diagnosis of islet cell tumor.Operation resection is the best choice for treatment of islet cell tumor.