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首页> 外文期刊>Surgical Endoscopy >Minimally invasive management of insulinomas. A case report.
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Minimally invasive management of insulinomas. A case report.

机译：胰岛素瘤的微创治疗。病例报告。

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BACKGROUND: Recently, preoperative endoscopic ultrasonography (EUS) was shown to be less time consuming, posing less risk of adverse events than other more invasive diagnostic procedures used for locating insulinomas. Furthermore, laparoscopy can be part of a less aggressive approach in the management of such tumors, avoiding open surgery, which is used all out of proportion for benign small-size lesions, as insulinomas frequently are. CASE REPORT: The reported case of pancreatic insulinoma involved a 45-year-old woman suffering from a neuroglycopenic syndrome. Tumor location was possible with endoscopic ultrasonography, which detected a hypoechoic 10 x 10-mm mass in the pancreatic tail. Tumor enucleation was accomplished laparoscopically. CONCLUSIONS: Insulinomas may be managed with videolaparoscopy, but this approach, which is not applicable for multiple or malignant tumors, must be contraindicated also in single insulinomas located on the posterior wall or deeply in the head of the pancreas. The disadvantages of the laparoscopic approach, as compared with conventional surgery, are the absence of palpation and difficulty exploring the whole pancreas, which is partly overcome, but not completely eliminated, by EUS. The advantages are the absence of a parietal incision and good postoperative comfort. The reported low-invasive EUS laparoscopy sequence may be successful in selected cases of pancreatic insulinomas. However, it seems this treatment could be proposed for many patients affected by this benign disease.
机译：背景：最近，术前内镜超声检查（EUS）被证明比其他用于定位胰岛素瘤的更具侵入性的诊断程序耗时少，不良事件发生的风险也较小。此外，腹腔镜检查可作为处理此类肿瘤的一种较不积极的方法的一部分，避免进行开放式手术，因为胰岛素瘤经常发生，这种手术不合比例地用于良性小尺寸病变。病例报告：所报告的胰腺胰岛素瘤病例涉及一名患有神经糖脂综合症的45岁妇女。内镜超声检查可以定位肿瘤，在胰尾部检测到低回声的10 x 10 mm肿块。腹腔镜完成肿瘤摘除术。结论胰岛素瘤可通过电视腹腔镜进行处理，但这种方法不适用于多发性或恶性肿瘤，对于位于后壁或胰头深处的单个胰岛素瘤也必须禁忌。与常规手术相比，腹腔镜手术的缺点是缺乏触诊和难以探查整个胰腺，而超声内镜已被部分克服，但并未完全消除。优点是无需壁切开切口，术后舒适度高。报道的低侵害性EUS腹腔镜检查序列可能在选定的胰腺胰岛素瘤病例中是成功的。但是，似乎可以为许多受这种良性疾病影响的患者建议这种治疗方法。

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