腹腔鏡下脾温存尾側膵切除術を行ったインスリノーマの1例

A Case of Laparoscopic Distal Pancreatectomy with Preservation of the Spleen for a Solitary Pancreatic Insulinoma

　患者は46歳，女性．インスリノーマによる低血糖症状を認めたため当院に紹介され，入院となった．術前の各種画像検査およびarterior stimulating venous sampling（ASVS）で膵尾部の単発性インスリノーマと判断し，腹腔鏡下脾温存膵尾部切除術を施行した．手術時間は235分，出血量330mlで，摘出標本の腫瘍径は16×11mmであった．切除直後から血糖値は速やかに上昇・安定し，術後7日目に退院した．インスリノーマに対する腹腔鏡下脾温存尾側膵切除術は低侵襲で有用な治療法であると考えられた．

A 46-year-old female was admitted to our hospital with recurrent attacks of hypoglycemia. The findings of biochemical and radiological examinations and Arterial Calcium Stimulating with Venous Sampling (ASVS) re-sulted in the diagnosis of a solitary insulinoma of the pancreatic tail. After the tail and body of the pancreas were mobilized, laparoscopic distal pancreatectomy with preservation of the spleen was performed without any com-plication. The operation time was 235 minutes and blood loss was 330 ml.