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胰岛细胞瘤的诊断主要是根据低血糖时存在不相称的血清胰岛素值升高。有饥饿症状、低血糖和血清胰岛素异常升高三联症者可确定诊断。手术切除胰岛细胞腺瘤是首选治疗,然而这些肿瘤通常小而难于定位,肿瘤定位是手术成功的关键。腹部超声扫描和CT不易在术前检出胰岛细胞瘤。选择性动脉造影是最好的定位方法,阳性率达75～80%。新近,经肝采胰腺区的门静脉血样可定位肿瘤,但不能特异而精确地作出定位。定位若不精确,则胰岛细胞瘤手术的发病率和死亡率极高。胰头部切开活检引起胰腺炎、假性囊肿和胰瘘等并发症发生率很高。盲目性远端胰切除术后,再逐步行近端胰切除所具有
The diagnosis of islet cell tumors is mainly based on the presence of disproportionately elevated serum insulin levels during hypoglycemia. Patients with triad syndrome who have symptoms of hunger, hypoglycemia, and elevated serum insulin can confirm the diagnosis. Surgical resection of islet cell adenomas is the preferred treatment. However, these tumors are usually small and difficult to locate. Tumor localization is the key to successful surgery. Abdominal ultrasound scan and CT are not easy to detect islet cell tumor before surgery. Selective angiography is the best localization method with a positive rate of 75-80%. Recently, portal vein blood samples from the pancreas can localize tumors, but they cannot be specifically and precisely located. If the positioning is inaccurate, the incidence and mortality of islet cell tumor surgery are extremely high. Pancreatic head biopsy has a high incidence of complications such as pancreatitis, pseudocysts and pancreatic fistulas. After blind distal pancreatic resection, it is gradually followed by proximal pancreatic resection.