胰腺神经内分泌肿瘤的手术治疗

Surgical management of pancreatic neuroendocrine neoplasms

  • 摘要: 胰腺神经内分泌肿瘤(pNENs)分为功能性与无功能性两大类,常见类型包括胰岛素瘤、胃泌素瘤、胰高血糖素瘤、血管活性肠肽瘤等,根治性手术切除是pNENs患者治愈和长期生存的唯一方法。基本手术方式包括局部切除和规则切除两类,前者为肿瘤局部切除(剜除)术,后者包括胰十二指肠切除术(标准或保留幽门)、胰体尾切除术(联合脾脏切除或保留脾脏)及中段胰腺切除术等。肝脏是最常见远处转移部位,手术切除是肝转移瘤首选治疗方法, RFA、TACE以及肝移植可以作为辅助治疗手段。

     

    Abstract: Pancreatic neuroendocrine neoplasms (pNENs) can be divided into functional and non functional. Insulinomas, gastrinomas, glucagonomas and VIPomas are the common types of pNENs. Radical resection is the only way for curing pNENs or for a long time survival of patients. The basic surgical procedures for pNENs are consist of local resection (tumor enucleation) or anatomical resection [pancreatoduodenectomy (standard or pylorus preserving pancreatoduodenectomy), distal pancreatectomy (combined with splenectomy or spleen preserving pancreatectomy) and middle segmental pancreatectomy]. Liver is the most common site for metastases. Surgical resection is the method of choice for liver metastases. Radiofrequency ablation, transcatheter arterial chemoembolization and liver transplantation could be the adjunctive therapies.

     

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