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继1979年60例胰岛素瘤报道以来,同年就胰岛素瘤再手术作了10例经验总结,最近又再手术4例,本文报道此4例再手术的一些经验教训,并就应用新技术诊断胰岛素瘤方面作了评价。周围血胰岛素测定及选择性血管造影(SAG)曾被采用于此4病例。经皮经肝门静脉插管分段取血(PTPVS)测胰岛素曾被采用于1例。4例中之3例再手术获得成功。1例失败者曾经三次探查:在首次胰岛素瘤切除术后低血糖仍持续:再次手术时未见肿瘤;在第三次手术前,SAG暗示有所异常,但术中仍未见肿瘤。由于门脉血胰岛素正常而使胰岛素瘤或
Since the report of 60 cases of insulinoma in 1979, 10 cases of insulinoma reoperation have been summarized in the same year and 4 cases have been re-introduced recently. This article reports some experiences and lessons from this 4 cases of reoperation, and diagnoses insulinoma with new techniques. The evaluation was made. Peripheral blood insulin measurement and selective angiography (SAG) were used in these 4 cases. Percutaneous transhepatic vein cannula (PTPVS) measurement of insulin has been used in 1 case. Three of the four cases were re-successful. One case of failure was explored three times: Hypoglycemia persisted after first insulinoma resection: no tumor was seen during reoperation; before the third operation, SAG suggested an abnormality but no tumor was seen during the operation. Insulinoma may be due to normal portal blood insulin.