Pătraşcu Tr, Doran H, Beluşică L, Prunaiche M, Goanţă A, Vereanu I
Clinica de Chirurgie I. Juvara, Spitalul Clinic Dr.I.Cantacuzino, Str. I. Movilă, nr.5-7, sector 2, Bucureşti.
Chirurgia (Bucur). 2003 Nov-Dec;98(6):509-14.
Insulinomas represent the most common cause of organic hypoglycemia. They are rare tumors: a review of the world literature reported a total number of 2000-3000 cases. The clinical diagnosis is based on the Whipple triad, which consists of: a) symptoms of hypoglycemia, b) blood glucose level: 40-50 mg/dl during the crisis, c) relief of symptoms after oral or intravenous administration of glucose. The most ticklish problem is the settlement of the accurate location of the tumor. Nowadays, there are many diagnostic methods; one of the best appears to be intra-operative ultrasonography. The authors analyse a series of 16 patients, operated between 1985 and 2002 in "I. Juvara" Surgical Clinic and present their opinions concerning tactic and technical aspects of different surgical procedures, with their advantages and limits. The results of the surgical treatment are detailed. There are also mentioned new imagery techniques and laparoscopic procedures, from recent medical issues.
胰岛素瘤是器质性低血糖最常见的病因。它们是罕见肿瘤:一项对世界文献的综述报告的病例总数为2000 - 3000例。临床诊断基于惠普尔三联征,该三联征包括:a)低血糖症状,b)血糖水平:发作时为40 - 50mg/dl,c)口服或静脉注射葡萄糖后症状缓解。最棘手的问题是确定肿瘤的准确位置。如今,有许多诊断方法;其中最好的方法之一似乎是术中超声检查。作者分析了1985年至2002年在“I. Juvara”外科诊所接受手术的16例患者系列,并就不同手术程序的策略和技术方面及其优缺点发表了他们的意见。详细介绍了手术治疗的结果。文中还提及了近期医学问题中的新成像技术和腹腔镜手术。