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目的:探讨胰腺中段切除术在胰腺颈体部神经内分泌肿瘤治疗中的作用。方法:回顾性分析南京医科大学第一附属医院2004年12月~2013年2月实施的16例胰腺中段切除术治疗胰腺神经内分泌肿瘤患者的临床资料。结果:本组16例,其中男女各8例,平均年龄48.3岁。16例均施行胰腺中段切除术,其中1例联合胆囊切除术,1例联合胰腺钩突肿瘤切除术。术后病理:无功能胰岛细胞瘤11例,胰岛素瘤3例,胰腺类癌、VIP瘤各1例,切缘均阴性。肿瘤总计21枚,直径1.0~6.0 cm,平均2.8 cm。术后并发症:胰瘘6例次(37.5%),腹腔出血、腹腔积液、继发糖尿病各1例次(6.3%)。无围手术期死亡及再手术病例。所有患者均获得随访,随访1~98个月,均无肿瘤复发和转移。结论:对于胰腺颈体部的神经内分泌肿瘤,胰腺中段切除是一种安全可行的手术方式,可有效保留胰腺的内外分泌功能。
Objective: To investigate the role of mid-pancreatectomy in the treatment of neuroendocrine tumors in the pancreas neck. Methods: The clinical data of 16 cases of pancreatic neuroendocrine tumors treated by mid-section resection of pancreas from December 2004 to February 2013 in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Results: The group of 16 patients, including 8 men and women each, with an average age of 48.3 years. Sixteen patients underwent middle pancreatectomy, including one with cholecystectomy and one with pancreaticobulbar tumor resection. Postoperative pathology: 11 cases of non-functional islet cell tumor, 3 cases of insulinoma, 1 case of pancreatic carcinoid tumor and 1 case of VIP tumor. The margins were all negative. A total of 21 tumors, diameter 1.0 ~ 6.0 cm, an average of 2.8 cm. Postoperative complications included 6 cases of pancreatic fistula (37.5%), 1 case of peritoneal hemorrhage, ascites and secondary diabetes (6.3%). No perioperative deaths and re-operation cases. All patients were followed up for 1 ~ 98 months, no tumor recurrence and metastasis. Conclusion: For the neuroendocrine tumors of the pancreas and neck, the middle pancreas resection is a safe and feasible method of operation, which can effectively preserve the exocrine function of the pancreas.