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。

Nonfunctioning islet cell tumors:an analysis of 16 cases

Objective To explore the diagnosis and treatment of nonfunctioning islet cell tumors. Methods The clinical data of 16 patients with nonfunctioning islet cell tumor admitted from 1990 to 2006 were analyzed retrospectively.The tumor was located in the head of pancreas in 4 patients, and in the body or tail in 12 patients. The average diameter of the tumor was 12cm.Results Six patients underwent tumor enucleation,3 patients were subjected to pancreatoduodenectomy, 3 patients underwent distal partial resection of tumor bearing pancreas with splenectomy, and 3 patients had distal partial resection of tumor bearing pancreas without splenectomy.The curative resection rate was 93.75%(15/16).There was no operative mortality.In one case the tumor was unresectable because of widespread of the tumor and the patient died 5 months later. At 2-16 years followup, the 11 cases with benign tumor were alive. In 3of 4 cases with malignant tumor who underwent resection, the survival time was 1,2 and 6 years, respectively, and the other case has survived for 12 years and 8 months.Conclusions Gastrointestinal barium meal exam,ultrasonography, CT, MRI and ERCP are essential for the diagnosis.Surgical resection is the treatment of choice for nonfunctioning islet cell tumors, and the outcome is satisfactory.