胰腺内分泌肿瘤的外科治疗  

Surgical treatments of endocrine tumors of the pancreas.

作　　者：杨尹默[1] 张学民[1] 严仲瑜[1] 万远廉[1] 黄莚庭[1] 郭克建[2] 

机构地区：[1]北京大学第一医院外科,100034 [2]中国医科大学第一临床学院普通外科

出　　处：《中国实用外科杂志》2001年第5期292-294,共3页Chinese Journal of Practical Surgery

摘　　要：目的　提高胰腺内分泌肿瘤的诊疗水平。方法　回顾性分析 2 3例胰腺内分泌肿瘤病人的临床资料。结果　胰腺内分泌肿瘤以胰岛素瘤、非功能性胰岛细胞瘤及胃泌素瘤最为常见 ,肿瘤大小与症状轻重无关。该组胰岛素瘤均为良性 ,其它 6 0 %为恶性。血管造影、门静脉血激素水平测定及术中B超对胰岛素瘤的诊断阳性率分别为 6 7%、83%及 10 0 %。胰岛素瘤均行肿瘤摘除术 ;胃泌素瘤及MEN -Ⅰ因合并症急诊行全胃切除术 ;胰高血糖瘤行姑息切除术 ;非功能性胰岛细胞瘤恶性者因局部浸润及转移未予解除。结论　除非功能性胰岛细胞瘤外 ,胰腺内分泌肿瘤多有完整被膜 ,可行摘除手术 ,姑息切除亦可明显缓解症状。即使为恶性 ,预后亦好于胰外分泌肿瘤。Objective To improve the diagnostic programs and surgical procedures of endocrine tumors of the pancreas.Methods 23 patients with endocrine tumors of the pancreas,who were admitted to the department of surgery between 1983~1999,were retrospectively reviewed in this series.Results Insulinoma,nonfunctioning islet cell tumor,and gastrinoma were the commonest types in the various of endocrine tumors.The size the of the tumors was not related to the severity of the clinical symptoms.In this group all the insulinomas were benign,while 60% of the others was malignant.For the localization of insulinomas,the sensitive rates of selective angiography,PTPC,and intraoperative ultrasonography were 67%,83% and 100%,respectively.In ths series,all the insulinomas were treated by enucleation,both the gastrinomas and the MEN-Ⅰby total gastrectomy due to emergent complications,glucagonomas by palliative resection.The malignant nonfunctioing islet cell tumors could not be resected due to metastasis and local invason.Conclusion With the exception of nonfunctioning islet cell tumors,most of the islet cell tumors were well-encapsulated and could be resected by enucleation.The symptoms could also be released by paleiative procedures.The prognosis of endoorine tumors was further better than that of the pancreatic exocrine tumors even though the lesions were malignant.

关 键 词：胰腺内分泌肿瘤 诊断 治疗 胰岛肿瘤 

分 类 号：R736.7[医药卫生—肿瘤]