无功能性胰岛细胞瘤的诊断与治疗  

Diagnosis and Surgical Treatment of Nonfunctioning Islet Cell Tumor of the Pancreas

作　　者：吴志勇[1] 曹晖[1] 赵意平[1] 焦哲[1] 陈治平[1] 邝耀麟[1] 

机构地区：[1]上海第二医科大学仁济医院外科,200001

出　　处：《外科》1996年第4期149-152,共4页

摘　　要：报道8例无功能性胰岛细胞瘤。男女各4例,女性年龄平均为38岁,男性为57.25岁。肿瘤位于胰头部5例,体部3例;良性7例,恶性1例,发生囊性变者3例。肿瘤最大达25cm×15cm×13cm。3例行肿瘤摘除术;4例行胰头体部分切除、胰头断端缝闭,胰体断端与空肠Roux-en-Y吻合术:仅1例作活检。本组术前确诊为本病者仅1例,术前诊断率低主要是对本病的临床特征缺乏认识。根据临床特征,结合B超、ERCP、CT、血管造影以及囊液细胞学检查和囊液分析等,本病的术前诊断是可能的。本病如为良性,完整摘除肿瘤或连同肿瘤在内的胰腺部分切除;如为恶性,则手术适应证和手术方式的选择同胰腺癌。We report here 8 cases of nonfunctioning islet cell tumor of the pancreas. The mean age was 38 and 57.25 years in 4 female and in 4 male patients respectively. All cases presented a single tumor. In 5 cases the tumor originated in the head, and 3 in the body. Seven of them were benign, and one malignant. In one case the tumor was 3 cm in diameter, in seven of them lager then 6cm, the largest being 25cm×15cm×13cm. Three patients underwent tumor enucleation; four were treated with partial resection of the pancreas with the closure of the remnant head and anastomosis of the distal pancreas to the jejunum in Roux-en-Y; one underwent exploration and biopsy only. A definite preoperative diagnosis was made in only one patient; misdiagnosis was mainly due to unfamiliarity with the clinical features of-the disease. With the help of ultrasonography, ERCP, CT, selective angiography, and fine needle aspiration cytology, and cyst fluid analysis diagnosis could still be reached preoperatively. If the tumor proved to be benign, enucleation or partial pan-createctomy is adequate; should the tumor be malignant, procedures for treating carcinoma of the pancreas were indicated.

关 键 词：无功能性 胰岛细胞瘤 诊断 外科手术 

分 类 号：R736.7[医药卫生—肿瘤]