Diagnosis and treatment of insulinoma: report of 105 cases

To study the methods for diagnosis and treatment of insulinoma.

Clinical data from 105 patients with insulinoma who had been admitted to our hospital from July 1966 to December 1999 were retrospectively reviewed.

Fasting blood glucose values were less than 2.75 mmol/L in all the patients. Fasting serum insulin values in 60 patients were higher than 25 mU/L, average 65 mU/L. Before operation, carcinoma was detected in 2 of 45 patients by ultrasound scan, and in 10 of 35 by CT. Enucleation of insulinoma was performed in 60 patients. Operations included insulinoma resection (35 patients), distal resection of the pancreas (8), and biopsy (2).

Whipple's triad and the index of insulin release >0.3 are the major variables for diagnosis. Intraoperative exploration and ultrasound scan are the methods for the localization of insulinoma. Enucleation of benign insulinoma is preferred, but proximal or distal resections of the pancreas are required only for large, deep or multiple tumors.