A study of Diagnosis and surgical management of pancreatic insulinoma
Journal Title: Surgical Update: International Journal of Surgery and Orthopedics - Year 2018, Vol 4, Issue 1
Abstract
Introduction: Insulinomas are the most common functioning neuroendocrine tumors of the pancreas, occurring in almost 1-4 per 1 million persons each year. They pose a challenge for pre-operative localization. Many invasive and noninvasive methods exist for localization of an insulinoma. Intra-operative ultrasonography (IOUS) with palpation can be done for tumors not localized by conventional imaging modalities. Pancreas Preserving surgery is the treatment of choice. This article gives an overview on localization and surgical strategies for treatment of insulinoma. Materials and Methods: This is a retrospective data of the patients undergoing surgical treatment of insulinoma in the Osmania General Hospital, Hyderabad between 2007 to 2017. Demographic data, symptoms and diagnostic tests and type of resections were analyzed from medical records. All patients had a completeintraoperative exploration of the pancreas done by digital palpation and intra operative ultrasonography. Results: 10cases (6 males and 4 females) of insulinoma aged between 22 and 55 years, with a median age of 30 years were included in the analysis. The size of the insulinoma ranged between 1.2 to 3 cm with average size of 2.14cm. 8 patients presented with Neuro glycopenicsymptoms howeversympatho adrenergic symptoms were present in all cases. Different modalities were employed for pre-operative localization of these patients out of which 5 cases were localized with CT, 2 cases with MRI, 1 case with EUS, 2 of them could not be localized preoperatively were localized by IOUS. Tumor was in Head 2 cases, in the neck1 case and in the body/ Tail in 7 cases. 2 patients underwent Enucleation, 5 underwent distal pancreatectomy and splenectomy, 2 underwent distal pancreatectomy and 1 underwent central pancreatectomy. 4 had pancreatic leak. All are symptom free and no episode of hypoglycemia at the time of discharge. Conclusion: Insulinomas are the most common neuroendocrine tumors of the pancreas. Surgical resection is the treatment of choice for insulinomas. From a surgical standpoint, localization of the tumor is of critical importance. Intraoperative Ultrasonography with palpation gives good help in localizing the lesion.
Authors and Affiliations
Madhusudhan Chinthakindi, Kyyoda Prashanth, Ravimohan Thogari, Ramalingam Pratap Reddy
Keywords
Related Articles
- EP ID EP344114
- DOI 10.17511/ijoso.2018.i1.10
- Views 159
- Downloads 0
A hospital based clinico-pathological study of soft tissue tumors
Background: Soft tissue sarcomas can develop from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. They can be found in any part of the body, commonly seen in the trunk, head a...
Diagnostic laparoscopy in right iliac fossa pain
Background: Abdominal pain is a common problem in both males and females. Early Diagnosis is needed to rule out life threatening emergencies. Diagnosticlaparoscopy is very much useful in giving proper treatment and avoid...
A Study to evaluate the use of Steinmann pin as Poller screw for diameta physeal fracture of distal tibia to avoid angular deformity
Introduction: There are several important technical points that need to be observed when using an intra medullarynail to fix diametaphyseal fractures of distal tibia, mainly the angular deformity. Objective: We aimed to...
Retrospective observational study of performance in outcome of emergency appendicectomy
Objective: The present study is aimed to investigate variations in outcome of Emergency Appendectomy being conducted in Surgery Unit- II at ESIC Medical College, Joka, Diamond Harbour Road, Kolkata, West Bengal. The main...
Unusual presentation of follicular thyroid carcinomaas mandibular metastasis
Primary carcinoma of thyroid presenting as mandibular metastasis is a rare incidence. Most of the time patient presents with various other symptoms due to hematogenous spread of primary neoplasm. We are presenting a rare...