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目的 评价胰岛素瘤的各种定位诊断方法的阳性率和各种手术治疗方法。方法 回顾性地分析我院自 1978年 1月至 1998年 12月诊治的胰岛素瘤 41例。结果 术前B型超声、CT定位诊断阳性率分别为 41% (15 / 34 )和 48% (12 / 2 5 ) ,手术探查的阳性发现率为 92 % (36 / 39)、术中超声为 10 0 % (9/ 9)。肿瘤局部摘除术 2 0例 ,远段胰腺切除术 18例。结论 胰岛素瘤的术前定位诊断较为困难 ,手术探查和术中超声检查是定位诊断的最佳方法。胰岛素瘤行肿瘤摘除术的术后并发症发生率较低 ,是治疗良性胰岛素瘤的最佳方式 ;多发性胰岛素瘤或合并MENⅠ的胰岛素瘤应行胰腺次全切除术以避免复发。
Objective To evaluate the positive rate of various localization methods for insulinoma and various surgical methods. Methods Retrospective analysis of 41 cases of insulinoma diagnosed and treated in our hospital from January 1978 to December 1998. Results The positive rates of preoperative B-mode ultrasound and CT were 41% (15 / 34) and 48% (12 / 25) respectively. The positive rate of surgical exploration was 92% (36 / 39). The intraoperative ultrasound was 10 0 % (9/ 9). Local tumor removal was performed in 20 cases and distal pancreatectomy in 18 cases. Conclusions Preoperative localization diagnosis of insulinoma is difficult. Surgical exploration and intraoperative ultrasound examination are the best methods for localization diagnosis. The incidence of postoperative complications of insulinoma neoplasm removal is low, and it is the best way to treat benign insulinoma; multiple insulinoma or insulinoma with MENI should undergo subtotal pancreatectomy to avoid recurrence.