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目的总结胰岛素瘤的外科诊治经验。方法对13例胰岛素瘤患者的临床资料进行回顾性分析。结果本组患者均有典型的W h ipp le三联症表现,5例患者曾被误诊;术前B超、CT、选择性腹腔动脉造影、磁共振成像(MR I)的定位率分别为44%、50%、71%和33%;术中13例患者经触诊定位11例,2例经术中B超均获定位;术后12例治愈,1例死于复发。结论胰岛素瘤误诊率较高,必要的辅助检查有助于肿瘤的定位,手术方式的选择应根据肿瘤的部位、大小、数量而定,手术治疗效果良好。
Objective To summarize the experience of surgical diagnosis and treatment of insulinoma. Methods The clinical data of 13 patients with insulinoma were analyzed retrospectively. Results All patients had typical W h ipp le trilogy and 5 patients had been misdiagnosed. The preoperative B ultrasound, CT, selective celiac angiography and magnetic resonance imaging (MRI) localization rates were 44% , 50%, 71% and 33% respectively. Thirteen patients were palpated and located in 11 cases, and 2 cases were located by B ultrasound. 12 cases were cured and 1 died of recurrence. Conclusion The misdiagnosis rate of insulinoma is high. Necessary auxiliary examinations are helpful for the location of tumor. The choice of surgical method should be based on the location, size and quantity of tumor, and the effect of operation is good.