[Pancreatic insulinomas]

In the period of 1980-1999 (20 years) were operated 18 patients (8 males and 10 females) in "Colentina" Surgical Clinic, the average age being of 45 years, with hystopathologically confirmed insulinomas. The topography of these lesions was in the head of the pancreas (4), in the isthmus (5), in the body and tail (9). The classical clinical and biochemical signs were presented in 13 cases, the rest of the patients presenting atypical signs of disease. These patients had benefit from the surgical treatment. The approach was bi-subcostal in 11 cases and by upper and lower midline incision in the rest of cases. We practiced enucleation in 5 cases, corporeal-caudal pancreatico-splenectomy in 10 cases and cephalic pancreatico-duodenectomy in 3 cases. The malignancy of the tumour was hystopathologically confirmed in 30% of the situations. The postoperative mortality was in 3 cases, by acute pancreatitis, MSOF and myocardial infarction. We consider that in case of these generally benign tumours the most efficient therapy is the surgical one.