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| 1 | Pancreatic insulinomas:laparoscopic management显示文摘Insulinomas are rare pancreatic neuroendocrine tumors that are most commonly benign,solitary,and intrapancreatic. Uncontrolled insulin overproduction from the tumor produces neurological and adrenergic symptoms of hypoglycemia. Biochemical diagnosis is confirmed by the presence of Whipple's triad,along with corroborating measurements of blood glucose,insulin,proinsulin,C-peptide,β-hydroxybutyrate,and negative tests for hypoglycemic agents during a supervised fasting period. This is accompanied by accurate preoperative localization using both invasive and non-invasive imaging modalities. Following this,careful preoperative planning is required,with the ensuing procedure being preferably carried out laparoscopically. An integral part of the laparoscopic approach is the application of laparoscopic intraoperative ultrasound,which is indispensable for accurate intraoperative localization of the lesion in the pancreatic region. The extent of laparoscopic resection is dependent on preoperative and intraoperative findings,but most commonly involves tumor enucleation or distal pancreatectomy. When performed in an experienced surgical unit,laparoscopic resection is associated with minimal mortality and excellent long-term cure rates. Furthermore,this approach confers equivalent safety and efficacy rates to open resection,while improving cosmesis and reducing hospital stay. As such,laparoscopic resection should be considered in all cases of benign insulinoma where adequate surgical expertise is available. | Pantelis T Antonakis Hutan Ashrafian Alberto Martinez-Isla | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，16： | 8 |
| 2 | 15例胰岛素瘤诊治分析及文献复习显示文摘目的:结合文献复习探讨胰岛素瘤的诊治方法。方法 :回顾性分析20031—2014年南京医科大学附属淮安第一医院收治的15例胰岛素瘤患者的临床资料,结合相关文献资料进行诊断和治疗方法分析。结果:15例胰岛素瘤患者中,有9例具有典型的Whipple三联征。术前B超、CT、MRI诊断的阳性率分别为40.0%、90.0%、75.0%。4例肿瘤位于胰头部,2例位于胰体部,9例位于胰腺尾部,其中13例行手术治疗,术后病理结果显示均为胰岛素瘤。结论:胰岛素瘤因其临床表现的非特异性,易被误诊误治,完善的生化检查及影像学定位技术对胰岛素瘤的诊断具有重要意义。手术仍是目前治疗胰岛素瘤的主要方法,腹腔镜等微创手术的发展与应用将为胰岛素瘤提供更好的治疗方法。 | 姚迪 毛莉 崔兆辉 周莉 刘媛媛 陆卫平 | 2015 | 南京医科大学学报(自然科学版)2015，35，8： | 0 |
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