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Surgical management of patients with insulinomas: Result of 292 cases in a single institution.
J Surg Oncol. 2011 Feb; 103(2):169-74.JS

Abstract

BACKGROUND

Insulinoma is rare tumor with an incidence of approximately four cases per million per year. There are few large sample, single-center series that focus on the surgical management strategy of insulinomas.

PATIENTS AND METHODS

Medical records of patients diagnosed as insulinoma from 1990 to 2010 in Peking Union Medical College Hospital were reviewed retrospectively. Clinical data were collected and statistically analyzed.

RESULTS

A total of 328 patients were diagnosed with insulinomas; 292 of them underwent 320 operations, which included 46 laparoscopic surgeries. Tumor enucleation was the most common operative procedure. Multiple tumors were found in 30 cases; 17 cases were multiple endocrine neoplasia-1 syndrome. Thirteen patients with malignant insulinomas underwent tumor resection. Pancreatic fistula (PF) was the most frequent complication, and the incidence of clinical PFs (Grades B and C) was 14.4%. There was no significant statistical difference between open and laparoscopic surgery in blood loss, operative time, and complications. Metachronous tumors were noted in 11 patients.

CONCLUSION

Surgery is the best treatment of choice for insulinoma patients. Surgical approach depends on tumor size, location, and its pathological characters. Laparoscopic management of insulinomas is feasible and safe for tumors located in the body or tail of the pancreas. Open surgery combined with intraoperative ultrasonography is recommended to avoid omission of lesions in patients with multiple insulinomas. An aggressive surgical approach is indicated for malignant insulinoma patients.

Authors+Show Affiliations

Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China. zhao8028@263.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21259252

Citation

Zhao, Yu-Pei, et al. "Surgical Management of Patients With Insulinomas: Result of 292 Cases in a Single Institution." Journal of Surgical Oncology, vol. 103, no. 2, 2011, pp. 169-74.
Zhao YP, Zhan HX, Zhang TP, et al. Surgical management of patients with insulinomas: Result of 292 cases in a single institution. J Surg Oncol. 2011;103(2):169-74.
Zhao, Y. P., Zhan, H. X., Zhang, T. P., Cong, L., Dai, M. H., Liao, Q., & Cai, L. X. (2011). Surgical management of patients with insulinomas: Result of 292 cases in a single institution. Journal of Surgical Oncology, 103(2), 169-74. https://doi.org/10.1002/jso.21773
Zhao YP, et al. Surgical Management of Patients With Insulinomas: Result of 292 Cases in a Single Institution. J Surg Oncol. 2011;103(2):169-74. PubMed PMID: 21259252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of patients with insulinomas: Result of 292 cases in a single institution. AU - Zhao,Yu-Pei, AU - Zhan,Han-Xiang, AU - Zhang,Tai-Ping, AU - Cong,Lin, AU - Dai,Meng-Hua, AU - Liao,Quan, AU - Cai,Li-Xing, Y1 - 2010/12/22/ PY - 2010/07/14/received PY - 2010/09/14/accepted PY - 2011/1/25/entrez PY - 2011/1/25/pubmed PY - 2011/3/12/medline SP - 169 EP - 74 JF - Journal of surgical oncology JO - J Surg Oncol VL - 103 IS - 2 N2 - BACKGROUND: Insulinoma is rare tumor with an incidence of approximately four cases per million per year. There are few large sample, single-center series that focus on the surgical management strategy of insulinomas. PATIENTS AND METHODS: Medical records of patients diagnosed as insulinoma from 1990 to 2010 in Peking Union Medical College Hospital were reviewed retrospectively. Clinical data were collected and statistically analyzed. RESULTS: A total of 328 patients were diagnosed with insulinomas; 292 of them underwent 320 operations, which included 46 laparoscopic surgeries. Tumor enucleation was the most common operative procedure. Multiple tumors were found in 30 cases; 17 cases were multiple endocrine neoplasia-1 syndrome. Thirteen patients with malignant insulinomas underwent tumor resection. Pancreatic fistula (PF) was the most frequent complication, and the incidence of clinical PFs (Grades B and C) was 14.4%. There was no significant statistical difference between open and laparoscopic surgery in blood loss, operative time, and complications. Metachronous tumors were noted in 11 patients. CONCLUSION: Surgery is the best treatment of choice for insulinoma patients. Surgical approach depends on tumor size, location, and its pathological characters. Laparoscopic management of insulinomas is feasible and safe for tumors located in the body or tail of the pancreas. Open surgery combined with intraoperative ultrasonography is recommended to avoid omission of lesions in patients with multiple insulinomas. An aggressive surgical approach is indicated for malignant insulinoma patients. SN - 1096-9098 UR - https://www.unboundmedicine.com/medline/citation/21259252/Surgical_management_of_patients_with_insulinomas:_Result_of_292_cases_in_a_single_institution_ L2 - https://doi.org/10.1002/jso.21773 DB - PRIME DP - Unbound Medicine ER -