Insulinoma
Insulinoma
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DOI：
10.1016/j.bpg.2005.05.008
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发表时间：
2005-10-01
影响因子：
3.2
通讯作者：
Grant, CS
中科院分区：
文献类型：
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作者：
Grant, CS
虽然罕见，胰岛素瘤是最常见的功能性胰岛细胞肿瘤的胰腺。识别关键的神经性低血糖症状应触发初步调查。内源性高胰岛素血症性低血糖的生化证据确立了诊断。有几种方法可用于这些肿瘤的成像和定位，包括超声检查、计算机断层扫描和静脉采样动脉内钙刺激。肿瘤通常是小的、单个的、良性的、边界清楚的，并且均匀地分布在整个胰腺中。这种肿瘤可能是多发性内分泌瘤I型（MEN-1）综合征的一部分，在这种情况下，肿瘤几乎总是多发的。手术治疗是唯一的治愈方法，传统上通过摘除或部分胰腺切除来完成。良性胰岛素瘤患者几乎无一例外地通过完全切除而终身治愈。这一领域的最新进展是认识到非胰岛素瘤胰源性低血糖综合征是器质性低血糖的原因，以及腹腔镜技术切除这些肿瘤的发展。
Although rare, insulinomas are the most common functioning islet cell tumour of the pancreas. Recognition of the key neuroglycopenic symptoms should trigger the initial investigation. Biochemical proof of endogenous hyperinsulinemic hypoglycemia establishes the diagnosis. Several options are available for imaging and localizing these tumours including ultrasonography, computed tomography, and intra-arterial calcium stimulation with venous sampling. The tumours are usually small, single, benign, well-circumscribed, and evenly distributed throughout the pancreas. This tumour may be a part of the multiple endocrine neoplasia type I (MEN-1) syndrome, in which case the tumours are almost always multiple. Surgical treatment is the only curative method, traditionally accomplished with enucleation or partial pancreatic resection. Patients are almost invariably cured lifelong with complete excision of a benign insulinoma. The most recent developments in this area are the recognition of noninsulinoma pancreatogenous hypoglycemia syndrome as a cause of organic hypoglycemia, and the development of laparoscopic techniques to excise these tumours.