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[Insulinomas--nesidioblastomas. Clinical experience]

A Popovici1, A Petca, M Grigoroiu

  • 1Clinica de chirurgie generală, Spitalul Clinic Fundeni.

Chirurgia (Bucharest, Romania : 1990)
|February 6, 1998
PubMed
Summary
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This study analyzed 16 insulinoma patients operated on between 1980-1996. Surgical outcomes revealed a 25% malignancy rate and a 12.5% postoperative mortality, highlighting challenges in insulinoma management.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Insulinomas are rare pancreatic neuroendocrine tumors responsible for endogenous hyperinsulinemic hypoglycemia.
  • This study reviews surgical management and outcomes of pathologically confirmed insulinomas over a 16-year period.

Observation:

  • A total of 16 patients (10 female) with insulinomas were surgically treated, representing 1.1% of all pancreatic tumors.
  • The median age was 47.2 years. Tumors were located in the head (2), body/tail (11), and diffuse forms (3).
  • Clinical presentations varied, including tumoral syndrome without hypoglycemia, splenic-portal hypertension, and intraoperative discoveries.

Findings:

  • Surgical approaches included midline, subcostal, and other incisions, with tumor exeresis via enucleation, segmentary pancreatectomies, and spleno-left-pancreatectomies.

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  • Tumors were not identified intraoperatively in three cases, necessitating blind resections.
  • The malignancy rate was 25% (4/16 patients), and the postoperative mortality rate was 12.5% (2/16 patients) due to pancreatitis and pulmonary embolism.

    • Implications:

    • The findings underscore the complexity of insulinoma surgical management, including diagnostic challenges and varied presentations.
    • A significant malignancy rate and postoperative mortality highlight the need for careful surgical planning and execution.
    • Further research into improved diagnostic modalities and tailored surgical strategies for insulinomas is warranted.