胰腺疾病的诊治在临床上一直是一个难点。在过去的几年中我们见证了放射学和核医学成像的技术进步。考虑到这一点，我们尝试描述超声内镜（EUS）在胰腺癌（PC）诊断及分期的过程中新的角色。到目前为止对于PC最准确的成像技术是对比增强计算机断层扫描（CT）和EUS。后者在检测微小病灶及评估肿瘤大小和淋巴结情况时具有最高的精度，但对于一个可疑的胰腺病变的患者而言，螺旋CT或最新的磁共振成像（MRI）仍是首要的选择。如在CT、MRI扫描为阴性结果而临床上高度怀疑PC，或是CT/MRI扫描后可疑病变需细胞组织学确认时，可应用EUS。相信在不久的将来用于诊断和治疗胰腺疾病的EUS将有更大的发展空间，并且病理结果将为其提供最好的应用证据。

Objective: To investigate the clinical efficacy of middle pancreatectomy (MP) for benign or low-grade malignant tumors of the pancreatic neck and body. Methods: The clinical data of 32 patients undergoing MP for benign or low-grade malignant tumor of the pancreatic neck body (MP group) from August 2005 to February 2013 were retrospectively analyzed, and were also compared with the data of 30 patients undergoing pancreaticoduodenectomy (PD group) and 36 patients undergoing distal pancreatectomy (DP group) for benign or low-grade malignant pancreatic tumor during the same time period. Results: In MP, PD and DP group, the average operative time was (180.8±56.4), (279.6±79.2) and (190.4±62.3) min, average intraoperative blood loss was (196.5±185.7), (482.6±288.5) and (320.7±240.3) mL, time to bowel function recovery was (3.6±1.6), (5.2±2.3) and (4.1±1.9) d, number of newly developed diabetetic cases was 1, 5 and 9, and number of cases with postoperative pancreatic enzyme requirement was 0, 8 and 5, respectively. The differences in all above parameters among the three groups had statistical significance (all P<0.05). The incidence of postoperative pancreatic fistula in MP, PD and DP group was 18.8%, 12.5% and 25.0% respectively, which along with other perioperative variables among the three groups showed no statistical difference (all P>0.05). During the average follow-up period of 38 months, no tumor recurrence was noted in any of the groups. Conclusion: MP is a proper procedure for benign or low-grade malignant tumors in the neck and body of the pancreas, which allows better preservation of both exocrine and endocrine functions of the pancreas.

Pancreatogenic hypoglycemia is a condition of relatively low prevalence but, once detected, it should be treated promptly to prevent irreversible brain damage, and surgery remains the first option in treatment of this condition. At present, the modalities in preoperative diagnosis of this condition, especially in localization techniques is continually evolving, and the treatment methods, except for surgical resection, include anhydrous alcohol injection, radiofrequency ablation, interventional embolization, and most recently, high-intensity focused ultrasound ablation therapy also achieved favorable results in treatment of pancreatogenic hypoglycemia. In this paper, the authors present the progress on surgical diagnosis and treatment of this condition, and propose the direction of future research.