Nihon Geka Gakkai zasshi · 1984
[Islet cell tumor:insulinoma].
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Kuroda A, Morioka Y, Kasahara K, Tenmoku S
Аннотация
UNLABELLED: Twenty-eight patients with insulinoma treated at our institutions during the years 1935-1983 were available for this study. These patients included 15 males and 13 females ranging 20 to 77 years of age and averaging 48 years.
DIAGNOSIS: Inappropriate elevations of plasma insulin (IRI/BS greater than 0.3) in the fasting state were demonstrated in all 18 patients. Accurate tumor localization was defined by arteriography in 61% of 18 patients. Decision of localization by transhepatic portal catheterization and insulin assay was successful in all of 4 patients in whom it was performed. Pathology: Twenty-five patients had a single tumor and 3 had multiple tumors. The tumor was located in the head in 8, in the body in 12 and in the tail in 14. Thirty of 34 tumors were benign and 4 were malignant.
SURGICAL TREATMENT: Enucleation was performed in 6 patients, 19 patients underwent distal pancreatectomy and one patient had pancreatoduodenectomy, One patient with occult tumor in the head had 80% resection of the pancreas. One patient with two tiny occult tumors close to the duodenum underwent distal left to right pancreatectomy finally resulting in total pancreatectomy.
RESULT: There was no operative death and no recurrence of symptoms in all patients after operation.
DIAGNOSIS: Inappropriate elevations of plasma insulin (IRI/BS greater than 0.3) in the fasting state were demonstrated in all 18 patients. Accurate tumor localization was defined by arteriography in 61% of 18 patients. Decision of localization by transhepatic portal catheterization and insulin assay was successful in all of 4 patients in whom it was performed. Pathology: Twenty-five patients had a single tumor and 3 had multiple tumors. The tumor was located in the head in 8, in the body in 12 and in the tail in 14. Thirty of 34 tumors were benign and 4 were malignant.
SURGICAL TREATMENT: Enucleation was performed in 6 patients, 19 patients underwent distal pancreatectomy and one patient had pancreatoduodenectomy, One patient with occult tumor in the head had 80% resection of the pancreas. One patient with two tiny occult tumors close to the duodenum underwent distal left to right pancreatectomy finally resulting in total pancreatectomy.
RESULT: There was no operative death and no recurrence of symptoms in all patients after operation.