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Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head

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Published on: January 3, 2020

Insulinoma and anaesthetic implications.

Jyotsna Goswami¹, Pallavi Somkuwar, Yogesh Naik

¹Department of Anaesthesia, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.

Indian Journal of Anaesthesia

|June 16, 2012

Summary

This review covers insulinoma, a rare pancreatic neuroendocrine tumor. It emphasizes diagnosis, localization challenges, and anesthetic management, particularly glucose control during surgery for this hypoglycemia-inducing condition.

Keywords:

Anaesthetic management of insulinoma and glucose management insulinoma multiple endocrine neoplasia neuroendocrine tumours

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Area of Science:

Endocrinology
Surgical Oncology
Anesthesiology

Background:

Insulinoma is a rare, typically benign pancreatic neuroendocrine tumor.
It can be associated with multiple endocrine neoplasia type 1.
Diagnosis involves clinical, biochemical, and imaging methods, with localization posing a challenge.

Purpose of the Study:

To review the incidence, epidemiology, clinical features, diagnosis, localization, and treatment of insulinoma.
To highlight the critical aspects of anesthetic management for insulinoma surgery.

Main Methods:

Systematic literature search of PubMed, Cochrane Library, and Google.
Keywords included: Insulinoma, neuro-endocrine tumors, multiple endocrine neoplasia, hypoglycemia, anesthetic management, glucose management.

Main Results:

Surgical resection is the primary curative treatment with high success rates.
Intraoperative management focuses on maintaining optimal glucose levels (above 60 mg/dL) via glucose infusion and monitoring due to hypoglycemia risk.
Ultrasound and palpation aid intraoperative tumor localization.

Conclusions:

Effective management of insulinoma requires a multidisciplinary approach, integrating diagnostic and therapeutic strategies.
Careful anesthetic management, focusing on glucose homeostasis, is paramount for successful surgical outcomes in insulinoma patients.