Böttger T, Heintz A, Junginger T, Düber C, Beyer J
Klinik und Polikinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Chirurg. 1995 Jan;66(1):45-9.
Four of 59 patients with organic hyperinsulinism had multiple insulinomas and two patients a micro- and macroadenomatosis. Excluding patients with adenomatosis 3 of 10 tumors could be detected preoperatively by ultrasound (5 of 10 by CT). 6 of 7 macroadenomas could be visualized by angiography. Intraoperatively 9 of 10 macroadenomas were palpable. The nonpalpable tumor could be localized by intraoperative ultrasound. Pancreatic resection had better results than multiple enucleations. Excisional biopsy is recommended to exclude nesidioblastosis or microadenomatosis.
59例器质性高胰岛素血症患者中，4例有多发胰岛素瘤，2例有微小腺瘤和大腺瘤并存。排除腺瘤并存的患者后，10个肿瘤中有3个可在术前通过超声检测到（10个中有5个可通过CT检测到）。7个大腺瘤中有6个可通过血管造影显示。术中10个大腺瘤中有9个可触及。不可触及的肿瘤可通过术中超声定位。胰腺切除术的效果优于多次剜除术。建议进行切除活检以排除胰岛细胞增殖症或微小腺瘤病。
