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目的探讨无功能胰岛细胞瘤的临床特点和诊断治疗方法。方法回顾性分析23例无功能胰岛细胞瘤的临床资料。结果以腹部肿块(65.2%),腹痛腹胀(47.8%),梗阻性黄疸(26.1%)等为主要临床表现;经B超,CT,MRI等影像学检查均诊断为胰腺肿瘤,肿瘤平均直径为9.5cm。行胰十二指肠切除11例(47.8%),胰体尾切除+脾切除术5例(21.7%),其他7例(30.4%)。术后病理证实20例为良性(87.0%),3例为恶性(13.0%)。胰瘘(3例,13.0%)是主要的术后并发症,均经非手术方法治愈。随访恶性者3例中1例术后1年内死亡,另2例现已无瘤生存29个月和8个月;随访17例良性者,已分别生存1～7年。结论无功能胰岛细胞瘤的诊断应根据临床表现、实验室和影像学检查并结合术中的探查、术后病理综合确定,手术治疗预后良好。
Objective To investigate the clinical features and diagnosis and treatment of non-functional islet cell tumor. Methods Retrospective analysis of 23 cases of non-functional islet cell tumor clinical data. Results The main clinical manifestations were abdominal mass (65.2%), abdominal distension (47.8%) and obstructive jaundice (26.1%). Pancreatic tumors were diagnosed by imaging examination such as B-, CT-, MRI- 9.5cm. Pancreaticoduodenectomy in 11 cases (47.8%), pancreatic excision + splenectomy in 5 cases (21.7%), the other 7 cases (30.4%). Postoperative pathology confirmed 20 cases were benign (87.0%), 3 cases were malignant (13.0%). Pancreatic fistula (3 cases, 13.0%) was the major postoperative complication and was cured by non-surgical method. One of 3 patients with malignant follow-up died within 1 year after operation, and the other 2 patients survived without tumor for 29 and 8 months. Seventeen patients were followed up for 1 to 7 years. Conclusion The diagnosis of non-functioning islet cell tumor should be based on clinical manifestations, laboratory and imaging studies combined with intraoperative exploration, postoperative pathology to determine the overall prognosis of surgical treatment was good.