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经皮经肝门静脉插管术在诊断内脏区域激素分泌肿瘤中的应用(作者译)

[Percutaneous transhepatic portal vein catheterisation in the diagnosis of hormone-producing tumours in the splanchnic area (author's transl)].

作者信息

Luska G, Zick R, Otten G, Mitzkat H J

出版信息

Rofo. 1981 Nov;135(5):566-71. doi: 10.1055/s-2008-1056468.

Abstract

During 1980, percutaneous transhepatic portal vein catheterisation was carried out in eight patients with suspected hormone-producing tumours in an attempt to localise these. Seven patients with hyperinsulinism were suspected of having an insulinoma and one a gastrinoma. There were no complications following the catheterisation, and difficulties were reduced by the use of a special catheter. The blood samples were examined by radio-immunological methods for insulin or gastrin. On the basis of localised rise in hormone level, it was possible to diagnose three insulinomas and one gastrinoma in the pancreas. The beta-cell tumours were removed by enucleation or segmental resection, the gastrinoma by a Whipple's operation. Three patients showed an insulin gradient and sub-total pancreatectomies were performed. In one patient there was no definite abnormality in the insulin level and an operation has so far not been performed. Our experience indicates that this technique is difficult, bu is nevertheless a reliable method for localising hormone-producing tumours and surgery should not be carried out without it.

摘要

1980年期间,对8例怀疑患有激素分泌肿瘤的患者进行了经皮经肝门静脉插管术,试图对这些肿瘤进行定位。7例高胰岛素血症患者怀疑患有胰岛素瘤,1例怀疑患有胃泌素瘤。插管术后无并发症发生,使用特殊导管减少了操作难度。通过放射免疫法检测血样中的胰岛素或胃泌素。根据激素水平的局部升高,得以诊断出胰腺中的3例胰岛素瘤和1例胃泌素瘤。β细胞肿瘤通过剜除术或节段性切除术切除,胃泌素瘤通过惠普尔手术切除。3例患者显示有胰岛素梯度,遂进行了次全胰腺切除术。1例患者胰岛素水平无明确异常,迄今为止尚未进行手术。我们的经验表明,该技术操作困难,但却是定位激素分泌肿瘤的可靠方法,没有它不应进行手术。

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