Surgical treatment of pancreatic insulinomas in the era of laparoscopy

Background: Laparoscopic resection has been increasingly reported for pancreatic insulinomas. This report evaluates our experience with surgical treatment for pancreatic insulinomas in this era of laparoscopy and reviews the application, safety, and outcome of this surgical approach reported in the literature. Methods: In a consecutive series of 10 patients with pancreatic insulinomas, laparoscopic resection was performed for selected patients after routine preoperative localizations. The outcome of this operative strategy was reviewed together with reported cases involving laparoscopic resection of pancreatic insulinomas. Results: Laparoscopic distal pancreatectomy or enucleation was performed for four patients with tumors located at the body or tail of the pancreas, whereas open enucleation was performed for six patients with tumors located at the pancreatic head. Pancreatic leak developed in one laparoscopic and two open enucleations. A review of reported cases in the literature showed that 61 of 69 attempted laparoscopic pancreatic resections for insulinomas were performed successfully. All except two tumors were located at the body or tail of the pancreas. For 42 cases with detailed information, 41 tumors at the pancreas body or tail were removed successfully by enucleation (n = 24) or distal pancreatic resection (n = 17), and one tumor at the pancreatic head was enucleated successfully. Pancreatic fistula, the most frequent complication, occurred in 8 (19%) of 42 laparoscopic resections. Conclusions: Laparoscopic resection of pancreatic insulinomas is safe and feasible for tumors located at the body or tail of the pancreas. Its application for tumors located at the pancreatic head needs further evaluation.     

Neuroendocrine carcinomas of the pancreas with 'Rhabdoid' features

Neuroendocrine carcinomas of the pancreas are rare neoplasms whose morphologic features generally mirror those seen in neuroendocrine tumors in other organs. Rarely, however, they may display unusual morphologic appearances that can introduce difficulties for diagnosis. We report four cases of primary neuroendocrine carcinomas of the pancreas (islet cell tumors) that were characterized by prominent "rhabdoid" features of the tumor cells. The lesions occurred in two men and two women 37-79 years of age who presented with symptoms of biliary obstruction and epigastric pain; one patient had recurrent gastric ulcers and an elevated gastrin level. The tumors were located in the head and tail of the pancreas and measured 2.5-4.5 cm in greatest diameter. Histologic examination revealed sheets of monotonous tumor cells with uniform round nuclei showing dispersed chromatin and containing abundant densely eosinophilic cytoplasmic inclusions that displaced the nuclei toward the periphery. In all cases, the rhabdoid elements appeared to merge with areas showing a more conventional neuroendocrine morphology. Immunohistochemical studies in all cases showed strong cytoplasmic positivity of the rhabdoid tumor cells for chromogranin, synaptophysin, and cytokeratin. Recognition of this unusual morphologic appearance is of importance to avoid mistaking these lesions for other types of malignant neoplasm.     

Predictive factors associated with long-term survival in patients with neuroendocrine tumors of the pancreas

Background Neuroendocrine tumors of the pancreas are rare tumors. We identified predictive factors that are associated with long-term survival (≥5 years). Methods Fifty patients with a diagnosis of neuroendocrine tumors of the pancreas were retrospectively evaluated. The following factors were evaluated for disease-specific mortality: age, sex, primary tumor location, functional status, type of primary tumor treatment, presence or absence of liver metastases, timing of liver metastases occurrence, and type of liver metastases treatment. Aggressive treatment of the liver metastases included surgery, chemoembolization, or intrahepatic arterial infusion chemotherapy. Results Twenty-three patients (47%) had tumor located in the head of the pancreas, and 29 patients (58%) had nonfunctioning tumor. Thirty-nine patients (78%) had liver metastases. The median follow-up for the entire group was 35 months (range, 76–206 months). The median survival for the entire group was 40 months, and the overall 1-, 2-, and 5-year survival rates were 84%, 69%, and 36%, respectively. Factors that had a significant favorable effect on survival included curative resection of the primary tumor, metachronous liver metastases, absence of liver metastases, and aggressive treatment of the liver metastases. Conclusions Definitive surgical resection of the primary tumor, absence of liver metastases, metachronous liver metastases, and aggressive treatment of the liver metastases were predictors of long-term survival in patients with neuroendocrine tumors of the pancreas. Presented as a poster presentation at the Society of Surgical Oncology 55th Annual Cancer Symposium, Denver, Colorado, March 14–17, 2002.     

Treatment of malignant pancreatic islet cell tumors

Among 142 patients with islet cell tumor who were admitted to hospital between 1982 and 1999, 15 patients (10.6%) had malignant tumours. The mean age was 45.3 +/- 5.8 years. Islet cell tumors were located in the head and corpus of the pancreas in 26.6% and 26.6% of the patients, respectively, in the tail of the pancreas in 46.8% of the patients. The mean size of the tumor was 2.9 +/- 0.7 cm, in 6 patients (40%) liver metastases were found. US, CT and angiography which sensitivity were 72.7, 100 and 85.7%, respectively, were used for topical diagnosis of the islet cell tumors. 12 patients were operated on (15 operations) and 3 patients were treated conservatively by streptozocin. Surgical procedures included distal pancreatic resection (n = 11), enucleation of the tumor (n = 2), hepatic resection (n = 1), abdominal exploration (n = 1). In 2 patients palliative pancreatic resections were combined with transarterial embolization and devascularisation of the liver metastases and 2 patients were treated by systemic chemotherapy. To reveal malignancy before and during the operation was possible only by evaluation of distant metastases and the adjacent organs infiltration. In other cases to determine the diagnosis was possible only after planned histological identification of the resected specimens. 5-year survival rates after conservative and surgical treatment were 33% and 62.5%, respectively. In patients without distant metastases 5-year survival rate was 100%.     

Role of surgery in ductal carcinoma of the pancreas.

Data of 111 patients with ductal carcinoma of the pancreas examined over a decade (1979-1989) at the 1st Department of Surgery, "La Sapienza" University of Rome, are presented. 21.6% of them underwent pancreatic resection and 40.5% biliodigestive diversion. Resectability was 26.5% for tumors of the head, 11.8% for tumors of the body and tail, nil for diffuse tumors. Overall operative mortality was 13.5%. Only stage I patients were shown to be resectable for cure and benefited from surgery with 21% probability of 5-year survival.     

胰岛细胞瘤21例临床分析

目的:探讨胰岛细胞瘤的临床特征、治疗效果。方法:回顾分析我院近5年诊治胰岛细胞瘤21例的经验,总结胰岛细胞瘤的临床特征、诊治方法及其效果。结果:本组病例中,无功能性胰岛细胞瘤9例,胰岛素瘤12例,其中2例为多发性内分泌腺瘤。前者恶变率为55.6％(5/9),平均年龄为40岁;后者恶变率为8.3％(1/12),平均年龄为39岁。肿瘤位子胰头9例,胰体6例,胰尾6例。术前影像诊断明确肿瘤定位16例(占76.2％),其余5例经术中触摸探查和超声检查得到定位。肿瘤行局部切除术12例,胰体尾切除+胰空肠吻合术6例,肿瘤+脾脏切除术2例,Whipple手术1例。术后胰瘘发生率为33.3％(7/21),其是最常见的并发症,本组无手术死亡。结论:无功能胰岛细胞瘤恶变率显著高于胰岛素瘤(P相似文献   

Laparoscopic enucleation of a nonfunctioning neuroendocrine tumor at the head of the pancreas.

OBJECTIVE: Laparoscopy is a safe, feasible technique for benign pancreatic pathologies and has been increasingly reported for neuroendocrine tumors located at the body and tail of the pancreas. We report a case of successful enucleation of a nonfunctioning neuroendocrine tumor located at the head of the pancreas, in a patient with multiple endocrine neoplasia type I. METHODS: A 5-cm nonfunctioning neuroendocrine tumor at the pancreatic head was identified by computerized tomography scan. Laparoscopic ultrasound did not reveal additional tumors on any other part of the pancreas. RESULTS: Enucleation was successfully performed for this solitary tumor because of its favorable position. Histology revealed an islet cell tumor. No postoperative complications occurred and recovery was rapid. CONCLUSION: Laparoscopic enucleation of neuroendocrine tumor at the pancreatic head is safe and feasible for select patients.     

Solid and papillary epithelial neoplasms of the pancreas: aggressive resection for cure.

Solid and papillary epithelial neoplasms of the pancreas (SPENP) are extremely rare and usually affect young women. We retrospectively reviewed our experience with pancreatic neoplasms from 1986 to the present and identified nine patients with SPENP. All nine patients were female with a mean age of 32 years (range 16-66). All patients presented with gastrointestinal complaints including pain, mass, dyspepsia, or bloating and were subsequently diagnosed with a tumor of the pancreas by CT scan. All patients underwent surgical resection. Two patients had tumors located in the head of the pancreas and underwent a pancreaticoduodenectomy. The remainder had tumors located in the tail of the pancreas and underwent distal pancreatectomy. Pathology demonstrated solid and papillary or solid and cystic pseudopapillary neoplasm of the pancreas. Three tumors were positive for both vimentin and alpha-1 antitrypsin on immunohistochemical studies, and three were positive for neuron-specific enolase. All nine patients underwent curative resection and are alive without any evidence of recurrence with a mean follow-up of 5.4 years. SPENP is considered to be a low-grade malignancy with an excellent prognosis. Prompt diagnosis and surgical resection can result in cure.     

胰岛素瘤64例的诊断与外科治疗

目的 总结胰岛素瘤的诊断与外科治疗方法.方法 回顾性分析64例胰岛素瘤的临床资料.结果 64例均表现Whipple三联征.术前BUS、CT及强化CT、MRI、DSA诊断阳性率分别为46.9%(30/64),58.2%(23/39),66.7%(18/27),91.7%(11/12).IOUS诊断阳性率为92%(23/25).单个肿瘤58例,多发肿瘤6例.单发者位于胰头19例,其中直径4cm 1例,胰体17例,胰尾22例;多发者6例均为2枚肿瘤,4例位于胰体,2例分别位于胰体和胰尾各1枚.治疗行肿瘤局部切除39例,胰体尾切除13例加作脾切除6例,胰尾切除8例加作脾切除4例,胰体表面肿瘤直径2cm行腹腔镜下单纯肿瘤摘除1例,自左向右分段切除(盲切法)2例,行胰头十二指肠切除1例.良性肿瘤62例,恶性2例.术后胰瘘3例、急性胰腺炎4例均经非手术治愈.64例术后低血糖症状消失.62例良性胰岛素瘤术后随诊1～5年血糖正常,其中2例分别于术后4年和5年复发,再次手术发现胰尾近脾门处分别有直径1cm和1.5cm肿瘤,经胰尾切除后治愈.45例随访8年血糖正常,17例失访.2例恶性胰岛素瘤分别于术后3年和4年复发,因肝转移死亡.结论 Whipple三联征和测定IRI/G＞0.3是定性诊断的依据.术中触诊联合IOUS是最有效的肿瘤定位诊断方法.胰岛素瘤切除术是最佳的治疗方法.     

Surgical experience with pancreatic and peripancreatic neuroendocrine tumors: Review of 125 patients

Neuroendocrine tumors of the pancreas and peripancreatic area are rare entities with a wide spectrum of clinical presentation. This study retrospectively reviews the patients who underwent surgery for these tumors at The Johns Hopkins Hospital from 1949 to 1996, inclusive There were 125 patients (65 males and 60 females) whose mean age was 51 ± 1 years Fifty-eight patients (48%) had nonfunctional tumors, whereas 64 (52%) had functional tumors 35 (55%) insulinomas, 23 (36%) gastrmomas, three (5%) VIP-omas, two (3 %) glucagonomas, and one (1%) ACTHorna All patients with functional tumors presented with appropriate signs and symptoms of hormonal excess, 86% of patients with nonfunctional tumors presented with weight loss, abdominal pain, or jaundice Preoperaüve computed tomography (CT) correctly localized the tumor in 66 (76%) of 87 patients, angiography in 45 (58%) of 78 patients, and CT plus angiography in 54 (79%) of 68 patients Tumors were benign in 60 patients (48%), malignant m 65 patients (52%), and were located in the head, neck, or uncinate process of the pancreas in 54, body in 14, tail in 18, and duodenum in eight The most common operative procedures performed were 50 pancreaacoduodenectomies (40%), 39 distal pancreatectomies (31%), and 21 tumor enucleations (17%) Nine synchronous hepatic resections were performed for métastases Of the evaluable patients, 46 (43%) had postoperative complications, the most common of which were pancreatic fistula (16%), wound infection (15%), and delayed gastric emptying (8%) There were three in-hospital deaths (2 8%) With a mean follow-up of 55 ±6 months, there have been 30 additional deaths, 23 of which were related to disease progression The overall 2-, 5-, and 10-year actuarial survival rates were 82%, 65%, and 47%, respectively The 5-year survival for patients with functional tumors was 77% compared to 52% for those with nonfunctional tumors (P = 0 025), the 5-year survival for patients with benign tumors was 91% compared to 49% for those with malignant tumors (P = 0 0004) By univanate analysis the most powerful predictor of poor outcome for patients with malignant tumors (n = 60) was positive surgiad margins (P = 0 006) This single-institution experience documents low mortality and moderate morbidity for patients treated operatively for pancreatic and penpancreaac neuroendocrine tumors The most favorable outcomes are observed in patients with benign functional tumors and in those with completely resected malignant tumors Supported in part by a grant from the National Institutes of Health (R01-CA56130) Presented at the Thirty-Eighth Annual Meeting of The Society for Surgety of the Alimentary Tract, Washington, D C, May 11–14,1997     

非功能性胰岛细胞瘤16例临床分析

目的探讨非功能性胰岛细胞瘤的诊断和治疗方法。方法对近16年间收治的非功能性胰岛细胞瘤16例临床资料回顾性分析。其中位于胰头部4例,胰体尾部12例,瘤体长径平均12cm。结果行肿瘤摘除术6例,胰十二指肠切除术3例,行包括肿瘤在内的远端胰腺及脾脏切除3例,保留脾脏的胰体尾切除术3例,因肿瘤广泛侵浸未能切除1例。治愈性切除率为93.75%(15/16),全组无手术死亡。随访资料显示:11例良性肿瘤患者全部存活,已2～16年。5例恶性肿瘤患者中,1例因肿瘤广泛侵犯未能切除者,术后5个月死于多器官衰竭;1例胰体尾切除并左肝切除者存活2年;胰十二肠切除者2例,分别存活1年和6年,胰体尾切除加脾切除1例已存活12年8个月。结论钡餐,B超,CT,MRI,以及ERCP对该病有诊断价值,手术切除是治疗非功能性胰岛细胞瘤的主要方法,效果良好。     

胰岛素瘤腹腔镜外科治疗体会

目的 评估腹腔镜胰岛素瘤切除术的可行性和安全性。方法 2002年6月至2004年6月25例胰岛素瘤患者,分别行腹腔镜胰岛素瘤切除术（腹腔镜组,10例）和开腹胰岛素瘤切除术（开腹手术组,15例）,比较2组手术时间、术中出血量、术后住院天数和并发症发生率差异是否有统计学意义。结果 肿瘤发生部位、大小差异无统计学意义,手术时间、术中出血量和术后平均住院天数等差异均无统计学意义（P〉0．05）。并发症发生率方面,腹腔镜手术组仅1例并发胰瘘,开腹手术组3例并发胰瘘、2例并发腹腔感染、5例并发胸腔积液,开腹手术组并发症发生率显著高于腹腔镜手术组（P〈0．01）。结论 位于胰体或尾部的胰岛素瘤行腹腔镜下胰岛素瘤切除术是安全可行的,并且并发症发生率低于经典的开腹手术。     

胰岛素瘤的诊断和治疗：附30例报告

目的:总结探讨胰岛素瘤的诊断和治疗方法。方法:回顾性分析近11年来治疗的30例胰岛素瘤的临床资料。结果:全组30例均表现Whipple三联征。术前B超，CT，MRI诊断的阳性率分别为34.8 %(8/23)， 58.3 %(7/12)，71.4 %(5/7)，术中B超诊断的阳性率为87.5 %(7/8)。单个肿瘤27例，多发性肿瘤3例。单发者，位于胰头8例,胰体7例,胰尾12例;多发者，1例2枚肿块均位于胰体，另2例均为2枚肿块分别位于胰体和胰尾。行肿瘤局部摘除术21例,胰体尾切除术6例，胰体尾切除术＋脾切除术2例，胰十二指肠切除术1例。良性肿瘤29例，恶性1例。术后胰瘘4例,均经充分引流后治愈。30例术后低血糖症状均消失，随访27例，良性肿瘤术后4年复发1例，再次手术切除胰体肿块后治愈，恶性肿瘤术后3年复发，因腹腔转移死亡。结论:Whipple三联征,测定IRI/G比值是定性诊断的主要依据,术中扪诊联合术中B超是最有效的肿瘤定位手段,肿瘤摘除术仍为胰岛素瘤的主要术式。     

慢性胰腺炎合并胰管结石的外科治疗

目的 探讨慢性胰腺炎合并胰管结石的外科治疗方法.方法 回顾性分析66例慢性胰腺炎合并胰管结石患者的临床资料,将其分为4型:Ⅰ型28例分布在胰头部;Ⅱ型30例在胰体部;Ⅲ型1例在胰尾部;Ⅳ型7例在胰头、胰体、胰尾部主胰管.10例(Ⅰ型4例,Ⅱ型5例,Ⅳ型1例)经镇痛、抑酸、应用生长抑素、抗感染等治疗.10例(Ⅰ型)行内镜取石术.Ⅰ型14例行胰头十二指肠切除术和保留十二指肠胰头部分切除术;Ⅱ型25例行胰管切开取石+胰管空肠吻合术;Ⅲ型1例行胰尾部+脾切除术;Ⅳ型6例行Puestow-Gillesby和胰颈部离断+胰管探查取石+胰管两断端空肠Roux-en-Y吻合术.结果 62例随访2个月至15年,Ⅰ型术后结石复发4例,Ⅱ型2例,Ⅲ型0例,Ⅳ型3例.结论 慢性胰腺炎合并胰管结石确诊后应争取早日手术治疗,根据结石分布范围选择相应的治疗方式.正确的术前及术中诊断、分型及个体化处理在预防慢性胰腺炎合并胰管结石外科治疗后结石复发中有重要意义.     

Preoperative staging and assessment of resectability of pancreatic cancer

To study the accuracy of preoperative staging techniques for assessing resectability of pancreatic and ampullary adenocarcinoma, we entered 88 consecutive candidates into a prospective study of contrast-enhanced computed tomography, magnetic resonance imaging, angiography, and laparoscopy. Resectability was proved in 16 (29%) of 55 patients for the head of the pancreas, 1 (6%) of 17 for the body and tail of the pancreas, and 14 (88%) of 16 for the ampulla. The combined findings of computed tomography and angiography showed that more than 87% of pancreatic head tumors were unresectable because of vascular encasement, but neither modality sufficed alone. Small liver and peritoneal metastases were found in 15 (27%) of 55 cancers of the head of the pancreas, 11 (65%) of 17 cancers of the body and tail of the pancreas, and 1 (6%) of 16 cancers of the ampulla; computed tomography missed all but 2 of these instances of metastasis, but laparoscopy with biopsy identified 22 (96%) of 23 instances. Magnetic resonance imaging findings did not differ significantly from computed tomography and conferred no added benefit. Ninety percent of unresectable tumors were identified. Seventy-eight percent of pancreatic head cancers were resectable when all test results were negative vs 5% (2/37) when any test result was positive. This study demonstrates that accurate and efficient triage is possible for patients with cancer of the pancreas and ampulla.     

Mucin-producing tumors of the pancreas: clinicopathological features, surgical treatment, and outcome

Mucin-producing tumors (MPTs) of the pancreas are increasingly being recognized. To evaluate the appropriate surgical treatment and predict the prognosis of MPTs, we performed a retrospective clinicopathological study in 51 patients, 27 with benign tumors and 24 with borderline/malignant tumors. Three of the malignant tumors showed stromal invasion and lymph node metastasis on histological examination. Of the 24 patients with borderline/malignant tumors, 2 died of MPTs and 4 died of other diseases. At the last follow-up, 35 patients were alive and well. The 5-year postoperative survival rate was 90% for patients with benign tumors, and 78% of these with borderline/malignant tumors. Five of the patients with borderline/malignant tumors had multicentric tumors. Three of these patients underwent resection of the rest of the pancreas, 5, 6, and 8 years, respectively, after the first operation. Extended radical resection is required for malignant MPT with invasion of the pancreatic stroma. We prefer to perform pancreatogastrostomy or Imanaga's procedure to allow examination of the body and tail of the pancreas by endoscopic retrograde pancreatography after resection of the pancreatic head. Careful follow-up for a long period may be the most prudent approach for detecting multiple MPTs in the residual pancreas after surgical treatment. Received for publication on June 30, 1998; accepted on March 3, 1999     

胰腺实性假乳头状瘤的外科治疗

目的探讨胰腺实性假乳头状瘤（SPT）的特点、外科治疗的方法及效果.方法回顾性分析1999年1月至2005年7月间14例胰腺实性假乳头状瘤的临床病理资料.结果本组患者中男性1例,女性13例.14例肿瘤均为单发,9例位于胰头,4例位于胰体,1例位于胰尾.肿瘤直径平均7.2 cm.无特异性临床表现.CT平扫：肿瘤囊性、实质部分均为低密度影,边界清楚,可见钙化;增强后：肿瘤实质轻度强化,囊性结构动、静脉期均无强化.14例患者均行手术治疗,8例行肿瘤局部切除,2例行胰体部分切除加胰肠吻合术,1例行胰体尾加脾切除术,3例行Whipple手术.随访2～58个月,平均随访20.1个月,所有患者均存活,无复发、转移.结论胰腺实性假乳头状瘤是一种低度恶性的肿瘤;手术切除是有效的治疗方法,术式选择与肿瘤位置、大小等因素相关;完整切除者预后良好.     

胰腺间变癌的诊断和治疗

目的探讨胰腺间变癌的诊断和治疗。方法回顾性分析1999年1月至2010年6月复旦大学附属中山医院收治的10例胰腺间变癌患者的临床资料。患者术前行CT检查,根据肿瘤部位制订手术方案。术后进行后续放、化疗。采用电话和门诊进行随访,随访时间截至2013年3月。分析患者的临床特点、影像学改变、病理学特征、治疗过程及随访资料。对患者的临床与病理特征分析采用描述性统计,连续性变量以贾±s表示,分类变量以频数和百分率表示。结果10例患者中肿瘤位于胰头5例、胰颈部1例、胰体尾部4例。10例患者中行胰十二指肠切除术2例、胰十二指肠切除＋扩大淋巴结清扫术2例、胰十二指肠切除＋门静脉重建术1例、全胰切除1例、胰体尾＋脾切除术4例。病理检查：瘤体大小为2．0cm×2．0cm×2．0cm～14．0cm×12．0cm×9．0cm。肿瘤呈浸润性生长。5例胰头部肿瘤患者中,4例侵犯十二指肠、胆总管,1例侵犯肠系膜上静脉。门静脉;1例胰体尾肿瘤侵犯脾动脉。8例患者镜下见肿瘤侵犯神经,其中4例有淋巴结转移。免疫组织化学染色检查：10例患者细胞角蛋白7阳性,其中1例波形蛋白阳性。10例患者中,1例失访,2例未接受后续治疗,6例接受吉西他滨化疗,1例行介入治疗。9例随访患者术后生存时间为8～20个月,中位生存时间为12个月,8例患者因肿瘤复发和转移死亡。结论胰腺间变癌是导管腺癌的特殊类型,恶性程度极高。该病确诊依靠病理检查,术前影像学检查结果指导手术方案,术后对放、化疗不敏感。     

Coexistence of mucinous cystic neoplasm occurring in the head of the pancreas with annular pancreas: Report of a case

Mucinous cystic neoplasms (MCN) of the pancreas are rare tumors that are almost exclusively located in the body or the tail of the pancreas. A 60-year-old woman with no history of pancreatic disease was referred to our hospital with a chief complaint of dull pain in the upper abdomen. Abdominal computed tomography showed a multilocular cystic mass of 7.0 cm in the head of the pancreas, and endoscopic retrograde cholangiopancreatography showed no communication between the cystic mass and the main pancreatic duct. A pancreatoduodenectomy was performed for the complete resection of the tumor, and an annular pancreas was discovered by accident. The pathological examination of the tumor led to a definitive diagnosis of MCN with ovarian-type stroma. To our knowledge this is the first documented case of MCN occurring in the head of the pancreas and associated with annular pancreas.     

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。