Pancreatic insulinomas: Laparoscopic management.

Area of Science:

• Endocrinology
• Surgical Oncology
• Gastroenterology

Background:

• Insulinomas are rare pancreatic neuroendocrine tumors causing hypoglycemia due to excess insulin production.
• Diagnosis involves Whipple's triad, biochemical tests, and imaging for localization.
• Surgical management is the primary treatment for insulinomas.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic resection for benign insulinomas.
• To highlight the role of intraoperative ultrasound in laparoscopic insulinoma surgery.
• To compare laparoscopic resection with open surgery for insulinoma treatment.

Main Methods:

• Biochemical diagnosis confirmed by Whipple's triad and supervised fasting.
• Preoperative localization using imaging modalities.
• Laparoscopic resection, often with intraoperative ultrasound guidance, including enucleation or distal pancreatectomy.

Main Results:

• Laparoscopic resection demonstrates minimal mortality and excellent long-term cure rates for benign insulinomas.
• The laparoscopic approach offers comparable safety and efficacy to open resection.
• Benefits include improved cosmesis and reduced hospital stay compared to open surgery.

Conclusions:

• Laparoscopic resection is a highly effective and safe treatment option for benign insulinomas.
• Intraoperative ultrasound is crucial for accurate localization during laparoscopic procedures.
• This minimally invasive approach should be considered when surgical expertise is available.