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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
PubMed
Summary
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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.

Related Experiment Videos

  • 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.