摘要目的 总结本院收治的4例胰腺血管活性肠肽瘤(VIPoma)的临床资料,探讨VIP瘤的诊断和治疗方法.方法 对1991年11月至2006年9月收治的4例VIP瘤患者的临床表现、实验室检查、影像学检查、手术方式、病理学诊断进行回顾性分析.结果 顽固性腹泻和低钾血症是VIP瘤主要的临床表现,1例病变位于胰头部,其余3例均位于胰体尾部,其中1例为胰体部和胰尾部2处占位病变.2例合并肝脏转移.4例均经病理诊断为胰血管活性肠肽瘤,1例行胰十二指肠切除术,1例行胰体尾部切除术,1例行肿瘤切除及肝转移病灶切除,术后2次行肝脏转移病灶切除.1例因与肠系膜上静脉和十二指肠浸润生长,肝多发转移结节,未行肿瘤切除.3例症状得到治愈或缓解.结论 VIP瘤的诊断依赖于典型的临床表现,常合并肝脏转移,手术切除是最有效的治疗方法.
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abstractsObjective To evaluate the diagnosis and treatment of vipoma based on our experience on 4 cases.Method Clinical manifestations,laboratory examination,imaging features,surgical findings,and pathology of 4 patients with vipoma admitted in our hospital from 1991 were discussed.Results Watery diarrhea and hypokalemia were the main clinical manifestations.Hepatic metastasis OCCurred in two patients.Tumor located in the head of the pancreas in one case.Two tumors were shown in the pancreatic body and one tumor was in the pancreatic tail.Resection of tumor and hepatic metastatic lesions with repeat resection of metastases Was performed in 1 patient.Resection of the pancreatic body and tail was done in one patient.Pancreatoduodenectomy Was performed in one patient.Laparotomy only was done in one patient because of invasion of the superior mesenteric vein and duodenum.Conclusion Typical symptoms play an important role in the diagnosis of vipoma.Hepatic metastasis is common.Surgery is the most effective means for treatment.
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