胰岛细胞瘤32例诊治分析  

Diagnosis and Treatment of 32 Pancreatic Endocrine Tumor

作　　者：翁汉钦[1] 何小玲[1] 刘彤[1] 李富新[1] 朱理玮[1] 

机构地区：[1]天津医科大学总医院普通外科,天津300052

出　　处：《中国中西医结合外科杂志》2008年第5期446-449,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨胰腺内分泌肿瘤的诊断和外科治疗经验。方法:32例中行肿瘤摘除术18例,胰体尾联合脾切除术4例,胰十二指肠切除术4例,肿瘤切除并胃大部切除术2例,Whipple术3例,捆绑式胰体空肠吻合术1例。结果:B超、CT、MRI、DSA诊断胰岛细胞瘤的敏感性分别为62.5%、75%、80%、87.5%。术后并发症包括胰瘘、切口感染、腹腔内出血。结论:无功能胰岛细胞瘤恶性率显著高于功能性胰岛细胞瘤(P<0.01)。胰腺内分泌肿瘤的外科治疗方案主要取决于肿瘤的大小、定位和恶性度。对良性者宜行单纯肿瘤切除或胰腺部分切除,对恶性肿瘤应以扩大范围的根治性肿瘤切除术为主的综合治疗。Objective To Summarize the diagnosis and surgical treatment of pancreatic endocrine tumors（PETs）. Methods In 32 patients with pancreatic islet cell tumor, Local excision was performed in 18 patients, pancreatectomy plus splenectomy in 4 patients, pancreaticoduodenectomy in 4 cases, tumor excision plus subtotal gastrectomy in 2 cases, Whipple operation in 3 patients, distal pancreatectomy in 1 case. Results In this studied group, the positive rates of B - ultrasound, CT, MRI and DSA were 62.5%, 75.0%, 80.0% and 87.5% respectively. The main complications of surgery were pancreatic fistula, haemorrhage and infection of incision. Conclusion The malignancy rate in dysfunctional group of islet cell adenoma was significantly higher than that in the ftmctional ones （ P 〈 0.01 ）. Surgical strategy for PETs depends on the size and location of the tumor and the risk of malignancy. It should be performed simply tumor re- move or partial pancreas resection for benign pancreatic islet cell tumor.

关 键 词：胰腺内分泌肿瘤 胰岛细胞瘤 诊断 外科治疗 

分 类 号：R735.9[医药卫生—肿瘤]