[Diagnosis and treatment of insulinomas--analysis of 6 cases]

Six patients with insulinoma treated from 1977-1986 are analysed. All patients had symptoms of neuro-glucopenia, hypoglycemic coma and sympathetic irritation. The fasting blood glucose level was below 30 mg%. The fasting plasma IRI was 17.3-19.84 mu u/ml and the IRI/glucose ratio was greater than 0.3 in four patients. The symptoms disappeared after the tumor was removed in three patients. One patient was complicated by pancreatic fistula after tumor resection, but was cured by drainage. One patient who had multi-insulinomas undiagnosed preoperatively had Whipple's triad after operation. One was treated by other methods because of his cardiovascular disorders. The percutaneous transhepatic portal catheterization segment IRI assay is a reliable method, especially when combined with abdominal selective arteriography, for the pre-operative diagnosis of insulinoma. The IRI/glucose ratio is more reliable than either glucose or IRI alone.