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Pancreatic insulinomas
F Menegaux1, G Schmitt, M Mercadier
1Department of General and Gastrointestinal Surgery, Hôpital de la Pitié, Paris, France.
American Journal of Surgery
|February 1, 1993
Summary
Surgical treatment for pancreatic insulinoma, particularly benign adenomas, achieved a high recovery rate of 92%. While pancreatic fistulas were common, surgical intervention for insulinoma remains effective.
Area of Science:
- Endocrinology
- Surgical Oncology
- Gastroenterology
Background:
- Pancreatic insulinoma is a rare tumor causing hypoglycemia.
- Surgical management is the primary treatment modality.
- Historical treatment outcomes and complications require evaluation.
Purpose of the Study:
- To review surgical outcomes for pancreatic insulinoma.
- To assess preoperative localization methods and intraoperative findings.
- To analyze surgical techniques, complications, and long-term recovery rates.
Main Methods:
- Retrospective review of 30 patients with pancreatic insulinoma treated between 1967 and 1990.
- Analysis of surgical procedures (enucleation vs. resection), preoperative localization, and intraoperative palpation.
- Evaluation of postoperative morbidity, mortality, and long-term follow-up data.
Main Results:
- Twenty-nine patients underwent surgery, with 24 having benign adenomas.
- Preoperative localization improved significantly over time (59% overall, 94% post-1980).
- Pancreatic fistulas were the most common complication (43%), more frequent after enucleation.
- Excluding adenocarcinomas, the recovery rate was 92%, with 8% developing diabetes post-pancreatectomy.
Conclusions:
- Surgical treatment for pancreatic insulinoma, especially benign adenomas, yields high recovery rates.
- Enucleation is an increasingly favored surgical approach, though associated with higher fistula rates.
- Improved preoperative localization enhances surgical success for insulinoma.
- Careful surgical technique and management of complications are crucial for optimal patient outcomes.