Sailer R, Katoh E, Drüneklee D, Kovaciecek S, Berger M
MMW Munch Med Wochenschr. 1976 Apr 2;118(14):429-34.
The clinical picture of insulinomas is discussed with reference to the literature and 27 of our own cases. The neurological symptoms are usually more prominent, so that the diagnosis is delayed. The average delay between the onset of the disease and its recognition was 4 years. Whipple's triad is characteristic of insulinoma. Of the chemical laboratory investigations, the hunger and tolbutamide tests are the most reliable for the diagnosis. Because of the danger of brain damage, there is an absolute indication for operation. Conservative treatment is burdened with numerous side effects so that it is only considered as a temporary measure or for inoperable patients. In the overwhelming majority of cases, enucleation of the tumors from the pancreas is successful. The cure rate after successful operation is about 80%.
结合文献及我们自己的27例病例,对胰岛素瘤的临床表现进行了讨论。神经症状通常更为突出,因此诊断会延迟。从疾病发作到确诊的平均延迟时间为4年。Whipple三联征是胰岛素瘤的特征。在化学实验室检查中,饥饿试验和甲苯磺丁脲试验对诊断最可靠。由于存在脑损伤的风险,手术有绝对指征。保守治疗有许多副作用,因此仅被视为临时措施或用于无法手术的患者。在绝大多数病例中,从胰腺摘除肿瘤是成功的。成功手术后的治愈率约为80%。