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目的探讨胰腺内分泌肿瘤的临床特点和外科治疗方法。方法对收治的胰腺内分泌肿瘤33例患者的临床资料进行回顾性。结果 33例中胰岛素瘤18例,无功能性胰岛细胞瘤9例,胃泌素瘤4例,胰高血糖素瘤2例。其中29例进行根治行切除,4例因肿瘤无法切除而放弃手术,总手术切除率为87.8%,术后发生胰瘘5例,肠梗阻2例,无住院期间死亡病例。26例平均随访时间为(4.7±3.5)年(9个月至14年),其中恶性14例患者总的1年和3年生存率为71.4%和50.0%,在随访期间19例良性患者全部存活。结论手术切除是胰腺内分泌肿瘤最为理想的治疗方法。术前定性及术中定位尤为重要,术中胰腺探查结合术中B超是定位的关键。选择合适的术式有助于避免术后并发症的发生。
Objective To investigate the clinical features and surgical treatment of pancreatic endocrine tumors. Methods The clinical data of 33 patients with pancreatic endocrine tumors were retrospectively reviewed. Results There were 33 insulinomas in 18 cases, 9 nonfunctioning islet cell tumors, 4 gastrinomas and 2 glucagonomas. Twenty-nine patients underwent radical resection, and 4 patients gave up surgery because of unresectable tumors. The total resection rate was 87.8%. Postoperative pancreatic fistula occurred in 5 cases, intestinal obstruction in 2 cases, and no hospital deaths occurred. The average follow-up time of 26 patients was (4.7±3.5) years (9 months to 14 years). The total one-year and three-year survival rates of 14 patients with malignancy were 71.4% and 50.0%. During follow-up, 19 patients with benign disease were all Survive. Conclusion Surgical resection is the most ideal treatment for pancreatic endocrine tumors. Preoperative qualitative and intraoperative positioning are particularly important. Intraoperative pancreas exploration combined with intraoperative ultrasound is the key to positioning. Choosing the right procedure can help prevent postoperative complications.