Abboud Bassam, Boujaoude Joe
Department of General Surgery, Hotel Dieu de France Hospital, Alfred Naccache Street, Beirut 166830, Lebanon.
World J Gastroenterol. 2008 Feb 7;14(5):657-65. doi: 10.3748/wjg.14.657.
Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike. Most are intrapancreatic, benign and solitary. Biochemical diagnosis is obtained and imaging techniques to localize lesions continue to evolve. Surgical resection is the treatment of choice. Despite all efforts, an occult insulinoma (occult insulinoma refers to a biochemically proven tumor with indeterminate anatomical site before operation) may still be encountered. New localization preoperative techniques decreases occult cases and the knowledge of the site of the mass before surgery allows to determine whether enucleation of the tumor or pancreatic resection is likely to be required and whether the tumor is amenable to removal via a laparoscopic approach. In absence of preoperative localization and intraoperative detection of an insulinoma, blind pancreatic resection is not recommended.
胰岛素瘤仍然给内科医生、外科医生和放射科医生带来诊断挑战。大多数胰岛素瘤位于胰腺内，为良性且孤立存在。已实现生化诊断，用于定位病变的成像技术也在不断发展。手术切除是首选治疗方法。尽管已竭尽全力，但仍可能遇到隐匿性胰岛素瘤（隐匿性胰岛素瘤是指术前经生化证实但解剖部位不确定的肿瘤）。新的术前定位技术减少了隐匿性病例的发生，术前了解肿块位置有助于确定是否可能需要摘除肿瘤或进行胰腺切除，以及该肿瘤是否适合通过腹腔镜手术切除。若术前未进行定位且术中未检测到胰岛素瘤，不建议盲目进行胰腺切除。
