Lo C Y, Lam K Y, Fan S T
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Pokfulam, China.
Am J Surg. 1998 Apr;175(4):305-7. doi: 10.1016/s0002-9610(98)00012-9.
Hyperinsulinemia in multiple endocrine neoplasia type I (MEN-I) is a rare but potentially curable condition that presents difficulties not encountered in sporadic cases.
The present report documents our surgical approach to 3 MEN-I patients with hyperinsulinemia.
Primary hyperparathyroidism was manifested in all 3 patients at the time of presentation. Distal subtotal pancreatectomy with enucleation of tumor at the head of pancreas detected intraoperatively resulted in immediate cure of 2 patients. Persistent disease occurred in 1 patient after enucleation of tumor at the head of the pancreas guided by preoperative imaging elsewhere. The patient was subsequently cured by distal subtotal pancreatectomy. Pathology revealed multiple tumors (4 to 14) in all patients.
A different surgical strategy with an aim of distal subtotal pancreatectomy and enucleation of any tumor identified in the head of pancreas is the treatment of choice for hyperinsulinemia in MEN-I patients.
I型多发性内分泌腺瘤病（MEN-I）中的高胰岛素血症是一种罕见但可能治愈的疾病，存在散发性病例中未遇到的困难。
本报告记录了我们对3例患有高胰岛素血症的MEN-I患者的手术方法。
所有3例患者在就诊时均表现为原发性甲状旁腺功能亢进。对术中发现的胰头肿瘤进行剜除术的远端胰腺次全切除术使2例患者立即治愈。1例患者在术前影像学检查发现其他部位病变后，对胰头肿瘤进行剜除术，术后疾病持续存在。该患者随后通过远端胰腺次全切除术治愈。病理显示所有患者均有多个肿瘤（4至14个）。
以远端胰腺次全切除术和剜除胰头发现的任何肿瘤为目标的不同手术策略是MEN-I患者高胰岛素血症的治疗选择。
