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

Clinical analysis of islet cell adenomas in 21 cases

Objective:To investigate the characteristics and effects of surgical treatment for patients suffering from islet cell adenoma.Methods:In recent 5 years,21 patients with islet cell adenoma were treated by the authors. The clinical characteristics of islet cell adenoma, and the surgical treatment results were analyzed retrospectively. Results: In this studied group,9 patients had dysfunctional islet cell adenomas. Another 12 ones suffered from functional islet cell adenomas(insuli-nomas) . Among of these,2 patients had another endocrine tumors. The malignancy rate in the two subtype groups were 55. 6% and 8.3% respectively. 9 tumors were located in pancreas head,6 in pancreas body,and 6 in pancreas tail. Preopera-tive location accuracy rate was 76.2% (16/21) ,the left were detected by operator' s explorations or with ultrasonography during the operations. 12 patients had been performed with local tumor excision,6 with distal pancrealectomies,2 with pan-createctomies plus splenectomies,and 1 with Whipple operation. Pancreatic leakage was the most common complication (33.3%). There was no perioperative mortality. Conclusion: The malignancy Rite in dysfunctional group of islet cell adenoma was significant higher than that in the functional ones( P < 0.01) . For those patients whose tumor could not be located preoperatively, combinations of ultrasound and palpation were useful. Local dissection of tumor maybe enough for benign tumors. Extensive operations should be considered in the large dysfunctional tumors or the insulinomas that were confirmed to be malignant by frozen section examination.