[Surgical treatment of insulinomas with observations on six cases in one year]

Insulinomas are among the endocrine pancreatic tumors most commonly met with. Regardless of their small proportion compared to other tumors of the digestive system, they give rise to pressing surgical problems on account of a number of reasons, namely: 1) early clinical diagnosis and undertaking opportune operative management in those presenting benign neoplasms, even in oligosymptomatic cases, 2) exact topical preoperative diagnosis using echography, CAT, MRI, angiography and the like; 3) intraoperative identification of the tumor/tumors in the event of multiple involvement, and choice of the most adequate operative approach, 4) intra- and postoperative monitoring of the blood sugar levels and appropriate insulin therapy prescription. Over the period Jan/Oct 1997, six patients presenting clinical, laboratory and instrumental evidence of insulinomas are subjected to operation in Department of General and Operative Surgery of the Medical University-Sofia. The basic principles with a reference to preoperative topical diagnosis and surgical tactics adopted, as well as postoperative care and monitoring of hyperglycemia developing as the result of surgery, are thoroughly discussed. Good immediate and long-term postoperative results are recorded in all six patients.