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Observational Study
. 2023 Aug 4;59(8):1423.
doi: 10.3390/medicina59081423.

Diagnosis and Surgical Management of Insulinomas-A 23-Year Single-Center Experience

David Hoskovec  1   2 , Zdeněk Krška  1   2 , Jan Škrha  2   3 , Pavol Klobušický  2 , Petr Dytrych  1   2
Affiliations
Observational Study

Diagnosis and Surgical Management of Insulinomas-A 23-Year Single-Center Experience

David Hoskovec et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Insulinoma is a rare tumor of the Langerhans islets of the pancreas. It produces insulin and causes severe hypoglycemia with neuroglycopenic symptoms. The incidence is low, at about 1-2 per 1 million inhabitants per year. The diagnosis is based on the presence of Whipple's triad and the result of a fasting test. Surgery is the treatment of choice. Objectives: A retrospective observational study of patients operated on for insulinoma in our hospital focused on the diagnosis, the type of surgery, and complications. Materials and Methods: We retrospectively reviewed patients operated on due to insulinoma. There were 116 surgeries between 2000 and 2022. There were 79 females and 37 males in this group. A fasting test and a CT examination were performed on all the patients. Results: The average duration of the fasting test was 18 h. Insulinoma was found in the body and tail of the pancreas in more than half of the patients. Enucleation was the most frequent type of surgery. Complications that were Clavien Dindo grade III or more occurred in 18% of the patients. The most frequent complications were abscesses and pancreatic fistula. Five patients had malignant insulinoma. Conclusions: Surgery is the treatment of choice in the case of insulinomas. The enucleation of the tumor is a sufficient treatment for benign insulinomas, which are not in contact with the main pancreatic duct. Due to the low incidence of the condition, the centralization of patients is recommended.

Keywords: Whipple’s triad; hypoglycemia; insulinoma; pancreas.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Insulinoma—CT arterial phase (tumor marked with an arrow).
Figure 2
Figure 2
Insulinoma—FDOPA PETCT (tumor marked with an arrow).
Figure 3
Figure 3
Insulinoma—perioperative view and enucleation.
See this image and copyright information in PMC

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References

    1. Maggio I., Mollica V., Brighi N., Lamberti G., Manuzzi L., Ricci A.D., Campana D. The functioning side of the pancreas: A review on insulinomas. J. Endocrinol. Investig. 2020;43:139–148. doi: 10.1007/s40618-019-01091-w. - DOI - PubMed
    1. Peltola E., Hannula P., Huhtala H., Metso S., Kiviniemi U., Vornanen M., Sand J., Laukkarinen J., Tiikkainen M., Schalin-Jäntti C., et al. Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland. Int. J. Endocrinol. 2018;2018:2059481. doi: 10.1155/2018/2059481. - DOI - PMC - PubMed
    1. Wei J., Liu X., Wu J., Xu W., Gao W., Jiang K., Zhang Z., Miao Y. Diagnosis and surgical management of insulinomas in 33 consecutive patients at a single institution. Langenbeck’s Arch. Surg. 2016;401:1019–1025. doi: 10.1007/s00423-016-1496-y. - DOI - PubMed
    1. Jyotsna V.P., Pal S., Kandasamy D., Gamanagatti S., Garg P., Raizada N., Sahni P., Bal C., Tandon N., Ammini A. Evolving management of insulinoma: Experience at a tertiary care centre. Indian J. Med. Res. 2016;144:771–777. doi: 10.4103/ijmr.IJMR_1477_14. - DOI - PMC - PubMed
    1. Durczyński A., Hogendorf P., Szymański D., Izdebski W., Kaczka A., Durko Ł., Strzelczyk J. Insulinoma—rare, but important clinical problem. Analysis of a Series of 530 Patients Who Underwent Surgical Treatment for the Pancreatic Tumor. Pol. J. Surg. 2015;86:505–510. doi: 10.2478/pjs-2014-0090. - DOI - PubMed

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