肿瘤局部切除治疗胰腺神经内分泌肿瘤的临床应用

目的探讨胰腺肿瘤局部切除术在胰腺神经内分泌肿瘤治疗中的作用。方法回顾性分析南京医科大学第一附属医院1999年1月至2011年12月实施的18例肿瘤局部切除术治疗胰腺神经内分泌肿瘤的临床资料。结果本组18例，其中男女各9例，平均年龄43．4岁。13例实行胰腺中段切除术，5例实行胰腺肿瘤切除＋胰腺空肠Roux—en—y吻合术。术后病理无功能胰岛细胞瘤12例，胰岛素瘤4例，胰腺类癌、VIP瘤各1例。肿瘤总计22枚，平均直径3．3（0．8—6．0）cm。术后并发症：胰瘘6例次（33．3％），腹腔出血2例次（11．1％），腹腔积液、切口感染、继发糖尿病各1例次（5．6％）。无围手术期死亡及再手术病例。随访11—161个月，均无肿瘤复发。结论对于胰腺神经内分泌肿瘤，肿瘤局部切除是一种安全可行的手术方式，可有效保留胰腺的内外分泌功能。

Local resection of pancreatic neuroendocrine tumors

Objective To study the value of local resection of pancreatic neoplasms in treating pancreatic neuroendocrine tumors（PETs）. Methods The clinical data of 18 patients with PETs undergoing local resection from Jan 1999 to Dec 2011 in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Results 18 patients （9 males and 9 females）were included, with the mean age of 43.4 years old. Among them, 13 patients underwent middle pancreateetomy（MP） ,5 patients underwent tumor enucleation and pancreas-jejunum Roux-en-Y anastomosis. Pathological results revealed that there were 12 cases of nonfunctional islet cell tumors, 4 cases of insulinomas, 1 case of pancreatic earcinoid, and 1 case of VIPoma. The diameters of the 22 tumors were from 0. 8 to 6. 0 em, 3.3 cm on average. Postoperative complications included pancreatic fistula in 6 patients （33.3 % ）, intra-abdominal hemorrhage in 2 patients （ 11.1% ）, intra-abdominal fluid collection, incisional infection and endocrine insufficiency all in 1 patients （5.6%）. No perioperative death and reoperation occured. During the follow up of 11 to 161 months, no local recurrence or metastasis happened. Conclusion Local resection of pancreatic neoplasms preserves endocrine and exocrine function, and is a safe and reliable procedure for pancreatic neuroendocrine tumors.