Kuroda A, Morioka Y, Kasahara K, Tenmoku S
Nihon Geka Gakkai Zasshi. 1984 Sep;85(9):1035-8.
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.
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.
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.
There was no operative death and no recurrence of symptoms in all patients after operation.
1935年至1983年间在我们机构接受治疗的28例胰岛素瘤患者可用于本研究。这些患者包括15名男性和13名女性，年龄在20至77岁之间，平均48岁。
所有18例患者在空腹状态下均表现出血浆胰岛素升高异常（胰岛素释放指数/血糖大于0.3）。18例患者中有61%通过动脉造影确定了肿瘤的准确位置。4例接受经肝门静脉插管和胰岛素测定进行定位的患者全部成功。病理：25例患者有单个肿瘤，3例有多个肿瘤。肿瘤位于胰头8例，胰体12例，胰尾14例。34个肿瘤中有30个为良性，4个为恶性。
6例患者进行了肿瘤剜除术，19例患者接受了胰体尾切除术，1例患者进行了胰十二指肠切除术。1例胰头隐匿性肿瘤患者进行了80%的胰腺切除术。1例有两个靠近十二指肠的微小隐匿性肿瘤的患者最终接受了从左到右的胰体尾切除术，导致全胰切除术。
所有患者术后均无手术死亡且症状未复发。
