[INVASIVE TECHNIQUES AND INTRAOPERATIVE ECHOGRAPHY IN THE LOCALIZATION OF INSULINOMAS; A CASE REPORT]

The insulinoma is the most common pancreatic neuroendocrine tumor. Surgery is curative in most cases, an appropriate preoperative localization allows a minimal invasive surgical technique for keeping the exo and endocrine function of the pancreas. Some authors suggest the use of invasive localization techniques just in cases with non-identified tumor lesion, others recommend their routinely use. We describe a case with clinical and biochemical diagnosis of insulinoma, conventional image studies revealed a tumor image in the pancreas which corresponded to a lipoma, the intraoperative ultrasound allowed the localization of the real tumor, but body-tail pancreatectomy was performed due to pancreatic necrosis in relation with the duration of the surgery. The systematic use of invasive localization techniques as the intra-arterial calcium stimulation and the pancreatic intraoperative ultrasound would allow a better localization of insulinoma for avoiding complications and associated morbidity.