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Related Experiment Videos

Insulinoma--experience from 1950 to 1995

M P Boukhman1, J H Karam, J Shaver

  • 1Department of Surgery, University of California, San Francisco/Mt. Zion Medical Center 94115, USA.

The Western Journal of Medicine
|September 15, 1998
PubMed
Summary
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This study analyzed 67 insulinoma patients, finding intraoperative ultrasonography crucial for localization. For Multiple Endocrine Neoplasia type I (MEN 1) patients, subtotal pancreatectomy is recommended over simple enucleation.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Insulinomas are rare pancreatic islet cell tumors.
  • Management requires careful consideration of tumor location and patient factors.

Purpose of the Study:

  • To analyze institutional experience with insulinoma patients.
  • To present a comprehensive approach to diagnosis and surgical management.

Main Methods:

  • Retrospective review of 67 patients treated between 1954 and 1995.
  • Analysis of presenting symptoms, diagnostic studies, surgical outcomes, and complications.
  • Evaluation of localization techniques, including preoperative studies and intraoperative ultrasonography.

Main Results:

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  • Surgical success rates varied: 96% for first operations (benign), 63% for reoperations (benign), and 50% for islet cell carcinoma.
  • Preoperative localization studies had limited utility (46% positive).
  • Intraoperative ultrasonography combined with palpation yielded the best localization results.

Conclusions:

  • Enucleation is curative for sporadic solitary tumors with low complication rates.
  • For MEN 1 patients, subtotal pancreatectomy with enucleation is preferred due to frequent multiple tumors.
  • Accurate localization, particularly intraoperative ultrasonography, is key to successful insulinoma management.