Do not wake up in the morning, fatigue often diarrhea ...
Ms. Li (pseudonym), 42,
Symptoms such as recurrent episodes of "hypoglycemia"
Plagued for 2 years,
Only to find out that the culprit is
Neuroendocrine tumors.
The tumor is invaded when the diagnosis is made
Pancreatic head and tail, liver, duodenum,
Part of the stomach, proximal jejunum, gallbladder, gallbladder
A total of seven major organs.
Recently, Professor Yin Xiaoyu, director of the Department of Biliary and Pancreatic Surgery of the First Affiliated Hospital of Sun Yat-sen University, completed a difficult "three-in-one" operation with the assistance of surgical robots, removed "a belly tumor" for her at one time, and Ms. Li was successfully discharged from the hospital more than 2 weeks after the operation.
Doctors remind: Under normal work and rest, such as frequent symptoms of hypoglycemia such as drowsiness in the morning and special difficulty in getting up, the physical examination should pay attention to the investigation of neuroendocrine tumors.
"Hypoglycemia" plagues
Two years turned out to be this disease!
"Repeated hypoglycemia, limb weakness, diarrhea, and worsening trend in the past two months." Ms. Li (pseudonym), who lives in Guangxi, was plagued by these uncomfortable symptoms for two years and was anxious to seek medical treatment, but the consultation was fruitless.
She has visited a number of tertiary hospitals in Guangxi, but the local hospitals have not been able to make a definitive diagnosis and determine the treatment plan.
Ms. Li went to the First Affiliated Hospital of Sun Yat-sen University for help, and the hospital's MDT (multidisciplinary diagnosis and treatment team) explored this unknown and stubborn disease: after consultation with multidisciplinary experts such as biliary and pancreatic surgery, gastroenterology, radiography, interventional radiology, pathology, etc., the doctors considered that the patient suffered from "multiple neuroendocrine tumor type 1" (multiple insulinomas of the head and tail of the pancreas, gastrinoma and liver metastasis, type II gastrointestinal endocrine tumors).
"Her condition is very complicated, the tumor not only appears in the liver, pancreas, stomach, but also secretes 2 hormones, which triggers a variety of symptoms." Professor Yin Xiaoyu said that compared with neuroendocrine tumors that do not secrete hormones, the treatment of functional neuroendocrine tumors that secrete hormones is relatively difficult, and tumors that secrete two hormones at the same time are also relatively rare.
For Ms. Li, the insulinoma caused her to increase insulin in her body, so that she had symptoms such as general weakness and hypoglycemia; the gastrin secreted by the gastrinoma caused her to have too much gastric acid, resulting in peptic ulcers, abdominal pain, diarrhea and so on.
High difficulty! One tumor at a time
Can such a tricky multiple endocrine tumor be cured? After the consultation and discussion, the experts made it clear that the patient still had indications for surgical resection, and the multidisciplinary experts decided to face the challenge head-on and fight backwater.
In order to completely remove the tumor and maximize the preservation of the patient's pancreas and spleen function, Professor Yin Xiaoyu's team decided to implement the "three-in-one" high-difficulty and complex operation of "robot-assisted pancreatic duodenal resection, left hemihepatic resection, and pancreatic tail resection" for patients with the assistance of surgical robots.
With the assistance of the surgical robot system, the "three-in-one" operation took 9 hours to complete smoothly
Professor Yin Xiaoyu said that the entire operation took more than 9 hours, and the pancreatic head and tail, liver, duodenum, part of the stomach, proximal jejunum, gallbladder, common bile duct and other seven major organ lesions were removed, and the intraoperative bleeding was only 200 ml.
After the operation, the patient recovered well, hypoglycemia, diarrhea and other symptoms completely disappeared, and after more than 2 weeks after the operation, he was successfully discharged from the hospital and is currently living and working normally.
Professor Yin Xiaoyu reminded that due to the particularity of the disease, patients do not need radiotherapy and chemotherapy after surgery, but they should still be vigilant against the possibility of recurrence and need regular follow-up monitoring.
Too cunning! The "invisible killer" has a variety of disasters
Professor Yin Xiaoyu said that neuroendocrine tumors are tumors that originate from neuroendocrine cells, which are divided into three categories: functional, non-functional and hereditary neuroendocrine tumors.
The most common pancreatic functional neuroendocrine tumors include insulinomas, gastrinomas, etc., and their symptoms are generally nonspecific, such as hypoglycemic reactions such as fatigue, palpitation, and cold sweating; diarrhea, abdominal cramps, etc. Neuroendocrine tumors are often referred to as "invisible killers", and more than 60% of patients are clinically diagnosed at an advanced stage.
At present, the preferred treatment for this tumor is surgical treatment, which reduces the blow to the patient's body by effectively reducing the tumor load. For patients who cannot take surgery, chemotherapy, interventional ablation and other means can also be used to "eliminate tumors".
Yin Xiaoyu introduced that nearly 70% of neuroendocrine tumors are non-functional, without any symptoms, and generally do ultrasound, CT and other imaging tests to be found; even if they are functional, most of the symptoms are non-specific.
"Some insulinoma patients will have symptoms of 'not waking up' in the morning and groggy, which should be taken seriously." He suggested that the general population should have regular physical examinations every year, perform ultrasound examinations, and detect tumors early, because the disease is relatively rare and extremely easy to misdiagnose, and it is recommended that patients seek help from medical teams with rich experience in admission and treatment.
Text, photo/Guangzhou Daily, Xinhuacheng Reporter: Ren Shanshan Correspondents: Peng Fuxiang, Liang Jiayun, Lai Yilin
Guangzhou Daily New Flower City Editor: Wu Yivan