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目的:探讨胰腺神经内分泌肿瘤的腹腔镜治疗方法及效果。方法:2014年6月至2017年6月采用完全腹腔镜手术治疗胰腺神经内分泌肿瘤5例,其中男3例,女2例,患者32~62岁。无功能胰腺神经内分泌肿瘤3例,2例表现为腹部不适,1例无症状;功能性胰腺神经内分泌肿瘤2例,均为胰岛素瘤,表现为反复发作的低血糖症状。病程1周~5年。结果:5例均成功施行完全腹腔镜胰腺神经内分泌肿瘤切除术,术后经病理证实符合胰腺神经内分泌肿瘤。手术时间65~420 min,出血量50(20,700)ml,输血1例。术后平均住院(6.4±2.3)d。术后胰腺生化瘘2例,经保守治疗后痊愈。无术后出血、腹腔感染等严重并发症发生。结论:腹腔镜手术治疗无功能性胰腺神经内分泌肿瘤具有创伤小、康复快的优点,是安全、有效的治疗方法。对于功能性胰腺神经内分泌肿瘤,在术前、术中精准定位的基础上,也可选择腹腔镜手术治疗。
Objective: To investigate the method and effect of laparoscopic treatment of pancreatic neuroendocrine tumors. Methods: From June 2014 to June 2017, 5 cases of pancreatic neuroendocrine tumors were treated by complete laparoscopic surgery, including 3 males and 2 females, ranging in age from 32 to 62 years. 3 cases of non-functional pancreatic neuroendocrine tumors, 2 cases of abdominal discomfort, 1 case of asymptomatic; functional pancreatic neuroendocrine tumors in 2 cases, are insulinoma, manifested as recurrent hypoglycemia. Course of 1 week ~ 5 years. Results: All patients underwent complete laparoscopic pancreatic neuroendocrine tumor resection successfully. The pathological findings were consistent with pancreatic neuroendocrine tumors after operation. Surgery time 65 ~ 420 min, bleeding 50 (20,700) ml, transfusion in 1 case. The average postoperative hospital stay (6.4 ± 2.3) d. 2 cases of postoperative pancreatic biochemical fistula, cured after conservative treatment. No postoperative bleeding, abdominal infection and other serious complications. Conclusion: Laparoscopic surgery for non-functional pancreatic neuroendocrine tumors has the advantages of less trauma and quick recovery, and is a safe and effective treatment. For functional pancreatic neuroendocrine tumors, preoperative and intraoperative accurate positioning, based on the choice of laparoscopic surgery.