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[Preoperative localization in organic hyperinsulinism--useful or superfluous]
1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität, Mainz.
Langenbecks Archiv Fur Chirurgie. Supplement II, Verhandlungen Der Deutschen Gesellschaft Fur Chirurgie. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1990
Summary
Preoperative diagnostic imaging for insulinomas, including sonography and CT, is not always essential but can aid localization. Intraoperative sonography offers high sensitivity for detecting these tumors.
Area of Science:
- Endocrinology
- Surgical Oncology
- Diagnostic Imaging
Context:
- Insulinomas are rare pancreatic neuroendocrine tumors.
- Accurate preoperative localization is crucial for surgical planning.
- Current diagnostic methods include ultrasound, CT, and angiography.
Purpose:
- To evaluate the sensitivity of various preoperative imaging techniques for insulinoma localization.
- To assess the efficacy of intraoperative sonography in detecting insulinomas.
- To determine the necessity of preoperative localization diagnostics for insulinoma surgery.
Summary:
- Percutaneous sonography sensitivity: 61.9%, CT: 73.3%, angiography: 66.6%, PTP: 76.9% in patient material (n=43).
- Intraoperative sonography (IOS) achieved 81.2% sensitivity, with 95.2% of insulinomas being palpable.
- German clinics commonly recommend preoperative sonography, CT, and angiography, suggesting localization is helpful but not strictly necessary.
Impact:
- Highlights the complementary role of intraoperative sonography in improving detection rates.
- Suggests that while preoperative diagnostics are common, their absolute necessity may vary.
- Informs surgical decision-making regarding the extent of preoperative localization required for insulinoma management.