STUDY AIM: To appreciate the impact of preoperative localization in surgical treatment of insulinomas. PATIENTS AND METHOD: From 1986 to 2001, 29 patients were surgically treated for suspected insulinoma. Preoperative imaging assessment was performed in 26 patients: ultrasonography (n = 21), computed tomography (n = 23), endoscopic ultrasonography (n = 13), intraoperative ultrasonography (n = 22) (2 of them under laparoscopic approach). RESULTS: The sensibility of the localization procedures was as follows: ultrasonography = 9.6%, computed tomography = 39%, endoscopic ultrasonography = 92.3%, surgical exploration 79.3%, intraoperative ultrasonography 86.3%. The sensibility of intraoperative palpation associated which intraoperative ultrasonography was 100%. Surgical procedures included: 11 enucleations, 10 segmental resections of the tail, 1 left pancreatectomy, 3 median pancreatectomies, 4 subtotal pancreatectomies. There was no postoperative mortality and postoperative morbidity rate was 17%, including 4 pancreatic leakages. Histological examination found solitary tumor in 22 patients (1 of them was a malignant tumor), multiple tumors (MEN 1) in 4 patients and factitious hypoglycemia in 3 patients. All the insulinomas were resected. CONCLUSION: Intraoperative evaluation of the pancreas with intraoperative ultrasonography was associated which a right localization in 100% of insulinomas. The place for preoperative imaging seems to be limited. A laparoscopic approach in sporadic insulinomas could modify this attitude.
STUDY AIM: To appreciate the impact of preoperative localization in surgical treatment of insulinomas. PATIENTS AND METHOD: From 1986 to 2001, 29 patients were surgically treated for suspected insulinoma. Preoperative imaging assessment was performed in 26 patients: ultrasonography (n = 21), computed tomography (n = 23), endoscopic ultrasonography (n = 13), intraoperative ultrasonography (n = 22) (2 of them under laparoscopic approach). RESULTS: The sensibility of the localization procedures was as follows: ultrasonography = 9.6%, computed tomography = 39%, endoscopic ultrasonography = 92.3%, surgical exploration 79.3%, intraoperative ultrasonography 86.3%. The sensibility of intraoperative palpation associated which intraoperative ultrasonography was 100%. Surgical procedures included: 11 enucleations, 10 segmental resections of the tail, 1 left pancreatectomy, 3 median pancreatectomies, 4 subtotal pancreatectomies. There was no postoperative mortality and postoperative morbidity rate was 17%, including 4 pancreatic leakages. Histological examination found solitary tumor in 22 patients (1 of them was a malignant tumor), multiple tumors (MEN 1) in 4 patients and factitious hypoglycemia in 3 patients. All the insulinomas were resected. CONCLUSION: Intraoperative evaluation of the pancreas with intraoperative ultrasonography was associated which a right localization in 100% of insulinomas. The place for preoperative imaging seems to be limited. A laparoscopic approach in sporadic insulinomas could modify this attitude.
Authors: Agustín Ramos-Prol; Maribel del Olmo-García; Antonia Pérez-Lázaro; María Caballero-Soto; María Argente-Pla; Beatriz León-de Zayas; Juan Francisco Merino-Torres Journal: Endocrine Date: 2010-10-23 Impact factor: 3.633
Authors: M Queiroz Almeida; M Cerqueira Cesar Machado; M L Correa-Giannella; D Giannella-Neto; M A Albergaria Pereira Journal: J Endocrinol Invest Date: 2006-09 Impact factor: 4.256
Authors: O Goletti; G Celona; F Monzani; N Caraccio; G Zocco; P V Lippolis; A Battini; M Seccia; E Cavina Journal: Surg Endosc Date: 2003-06-17 Impact factor: 4.584
Authors: G Kate Park; Jeong Heon Lee; Eduardo Soriano; Myunghwan Choi; Kai Bao; Wataru Katagiri; Do-Yeon Kim; Ji-Hye Paik; Seok-Hyun Yun; John V Frangioni; Thomas E Clancy; Satoshi Kashiwagi; Maged Henary; Hak Soo Choi Journal: iScience Date: 2020-03-25