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目的探讨胰岛细胞瘤的临床诊断和外科治疗方法。方法对某院2001.1~2010.12收治的胰岛细胞瘤25例患者的临床资料进行回顾,结合相关文献进行诊治分析。结果 25例患者中,非功能性胰岛细胞瘤12例,功能性胰岛细胞瘤13例。肿瘤位于胰头7例,胰颈4例,胰体尾14例。肿瘤直径0.5~20cm。13例功能性胰岛细胞瘤均有Whipple三联征。全部病例术前均行B超和/或CT检查,7例术前行DSA检查。25例患者均行手术治疗,单纯肿瘤切除16例,胰体尾部切除5例,胰体尾切除加脾切除2例,胰颈部切除1例,瘤灶切除后十二指肠修补+旷置+胰头-十二指肠空肠壁吻合1例。术后发生胰漏1例。全部患者治愈出院。结论 NIT无特异临床表现,但影像学检查能较有效检出。FIT临床主要表现为典型的Whipple三联征。CT和DSA是有效的术前定位方法。手术切除是胰岛细胞瘤治疗的最佳选择。
Objective To investigate the clinical diagnosis and surgical treatment of islet cell tumor. Methods The clinical data of 25 patients with islet cell tumor admitted in a hospital from January 2001 to December 2010 were retrospectively analyzed and analyzed with related literatures. Results Of the 25 patients, 12 were non-functional islet cell tumors and 13 were functional islet cell tumors. The tumor was located in the head of pancreas in 7 cases, 4 cases of pancreatic neck, pancreatic body tail in 14 cases. Tumor diameter 0.5 ~ 20cm. Thirteen cases of functional islet cell tumor Whipple triad. All cases underwent preoperative B ultrasound and / or CT examination, 7 cases preoperative DSA examination. Twenty-five patients underwent surgical resection. Tumor resection was performed in 16 cases, pancreatic body tail resection in 5 cases, pancreatic body tail resection plus splenectomy in 2 cases, pancreatic neck excision in 1 case, tumor resection duodenum repair + + Pancreatic head - duodenum jejunum wall anastomosis in 1 case. Postoperative pancreatic leakage occurred in 1 case. All patients were cured and discharged. Conclusion No specific clinical manifestations of NIT, but imaging examination can be more effective detection. FIT clinical manifestations of the typical Whipple triad. CT and DSA are effective preoperative localization methods. Surgical resection is the best choice for treatment of islet cell tumors.