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目的探讨胰岛素瘤的诊断与治疗方法。方法回顾性分析20例胰岛素瘤患者的临床资料,并结合国内外有关文献报道进行诊治分析。结果20例患者均行手术治疗,均经病理证实,其中良性胰岛素瘤16例,恶性胰岛素瘤3例,多发性瘤1例。20例均有Whipple三联征。本组术前均行B超及CT检查,12例有阳性发现,阳性率为60%,4例术中B超检查确定肿瘤部位,2例术中反复手法抠及,其余2例取可疑病灶快速病理诊断。行胰岛素瘤切除8例,胰尾切除8例,胰体尾切除加脾切除2例,胰十二指肠切除2例。20例术后血糖均恢复正常。术后发生胰漏2例。结论胰岛素瘤临床表现为典型Whipple三联征。外科手术是治疗胰岛素瘤的主要方法,手术方法应根据病变的性质、部位、数量等因素确定。
Objective To investigate the diagnosis and treatment of insulinoma. Methods The clinical data of 20 patients with insulinoma were retrospectively analyzed. The diagnosis and treatment were analyzed by combining domestic and international literature reports. Results Twenty patients underwent surgical treatment and were confirmed by pathology. Among them, 16 cases were benign insulinoma, 3 cases were malignant insulinoma, and 1 case was multiple tumors. Twenty patients had the Whipple triad. All patients underwent B-ultrasonography and CT examination before operation. Positive findings were found in 12 cases. The positive rate was 60%. 4 cases had intraoperative B-ultrasound examination to determine the tumor site, 2 cases had repeated intraoperative manipulations, and the remaining 2 cases took suspicious lesions. Rapid pathological diagnosis. Eight patients underwent insulinoma resection, 8 patients underwent pancreatic tail resection, 2 patients underwent pancreatectomy and splenectomy, and 2 patients underwent pancreatoduodenectomy. Blood glucose returned to normal in 20 cases. Postoperative pancreatic leakage occurred in 2 cases. Conclusion The clinical manifestation of insulinoma is a typical Whipple triad. Surgery is the main method for the treatment of insulinoma. Surgical methods should be based on the nature of the lesion, site, and quantity.