Kallio H, Suoranta H
Ann Surg. 1979 Jan;189(1):49-52. doi: 10.1097/00000658-197901000-00010.
Percutaneous transhepatic portal venography (PTP) and selective portal blood sample collection for immunoreactive insulin (IRI) analyses was done in four patients who had clinical evidence of the presence of an insulin secreting tumor, but selective arteriogrphy of the pancreas did not visualize any insulinomas. In all patients the clinical diagnosis was confirmed and the localization of the tumors could be calculated with the aid of the PTP and the IRI values detected in different parts of the portal trees. Because no tumor was found at the operation in two patients, despite careful exploration of the pancreas, blind distal pancreatectomy was performed to the point suggested with the help of the investigations, and insulinomas were found close to the resection lines. In the two other patients the proposed localization of the tumor preoperatively was confirmed. There have been no postoperative hypoglycemic symptoms.
对四名有胰岛素分泌肿瘤临床证据但胰腺选择性动脉造影未显示任何胰岛素瘤的患者进行了经皮经肝门静脉造影（PTP）和选择性门静脉血样采集以进行免疫反应性胰岛素（IRI）分析。在所有患者中，临床诊断得到证实，借助PTP以及在门静脉不同部位检测到的IRI值可计算出肿瘤的位置。尽管对两名患者的胰腺进行了仔细探查，但手术中未发现肿瘤，于是根据检查结果建议的部位进行了盲目远端胰腺切除术，结果在切除线附近发现了胰岛素瘤。在另外两名患者中，术前建议的肿瘤位置得到了证实。术后均无低血糖症状。
