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. 1999 Aug;134(8):818-22; discussion 822-3.
doi: 10.1001/archsurg.134.8.818.

Localization of insulinomas

M P Boukhman  1 , J M Karam, J Shaver, A E Siperstein, A A DeLorimier, O H Clark
Affiliations

Localization of insulinomas

M P Boukhman et al. Arch Surg. 1999 Aug.

Abstract

Hypothesis: Intraoperative ultrasonography is more sensitive than preoperative and other intraoperative techniques for localizing insulinoma.

Design: Retrospective review.

Setting: A tertiary referral center.

Patients: All patients with a biochemical diagnosis of organic hyperinsulinism who were referred to University of California, San Francisco, from 1975 to 1998.

Methods: Sensitivities of the localization techniques for insulinoma were evaluated.

Results: The sensitivities of tumor localization with arteriography, computed tomography, preoperative ultrasonography, magnetic resonance imaging, magnetic resonance imaging with gadolinium, transhepatic venous sampling, palpation, and intraoperative ultrasonography were 47%, 24%, 50%, 30%, 40%, 55%, 76%, and 91%, respectively. Nine of the 11 nonpalpable and nonvisible tumors at operation were localized by intraoperative ultrasonography.

Conclusion: The currently available preoperative localization tests are not reliable enough to be recommended when intraoperative ultrasonography is available.

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