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Article: Pancreatic insulinomas: A 15-year experience

TitlePancreatic insulinomas: A 15-year experience
Authors
Issue Date1997
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 1997, v. 132 n. 8, p. 926-930 How to Cite?
AbstractObjective: To describe our experience in the management of patients with pancreatic insulinomas, emphasizing the need for preoperative localization and the outcome of surgical treatment. Design: A case series. Setting: A university hospital in Hong Kong. Patients: From 1981 to 1995, 27 patients with pancreatic insulinomas were surgically treated; the mean follow-up was 25.4 months. Main Outcome Measures: Postoperative morbidity and euglycemia during the follow-up period. Results: The accuracy of tumor localization by ultrasonography, computed tomography, and angiography was 33%, 44%, and 52%, respectively. Venous sampling for an insulin assay regionalized 90% of the tumors. In 24 patients with solitary tumors, most lesions detected or missed by preoperative localization could be either seen (n= 14) or palpated (n=22). Intraoperative ultrasonography (n=17) has been routinely performed since 1987; nonpalpable tumors were imaged in 2 of 15 patients with solitary tumors. Eight solitary occult tumors were detected by palpation alone or a combination of palpation and intraoperative ultrasonography. Operative mortality occurred in 1 (3.7%) of the 27 patients, while major morbidity developed in 9 (33%) of the patients. Euglycemia was achieved in 25 patients. Surgery cured all patients with benign insulinomas, whereas the cure rate for patients with malignant neoplasms was only 33%. The type of surgical treatment or correct preoperative localization did not affect the outcome of surgery. Conclusions: Pancreatic insulinomas can be readily localized intraoperatively despite failed preoperative localization studies. Surgical treatment cured benign adenomas but was associated with notable morbidity.
Persistent Identifierhttp://hdl.handle.net/10722/162187
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CYen_US
dc.contributor.authorLam, KYen_US
dc.contributor.authorKung, AWCen_US
dc.contributor.authorLam, KSLen_US
dc.contributor.authorTung, PHMen_US
dc.contributor.authorFan, STen_US
dc.date.accessioned2012-09-05T05:17:53Z-
dc.date.available2012-09-05T05:17:53Z-
dc.date.issued1997en_US
dc.identifier.citationArchives Of Surgery, 1997, v. 132 n. 8, p. 926-930en_US
dc.identifier.issn0004-0010en_US
dc.identifier.urihttp://hdl.handle.net/10722/162187-
dc.description.abstractObjective: To describe our experience in the management of patients with pancreatic insulinomas, emphasizing the need for preoperative localization and the outcome of surgical treatment. Design: A case series. Setting: A university hospital in Hong Kong. Patients: From 1981 to 1995, 27 patients with pancreatic insulinomas were surgically treated; the mean follow-up was 25.4 months. Main Outcome Measures: Postoperative morbidity and euglycemia during the follow-up period. Results: The accuracy of tumor localization by ultrasonography, computed tomography, and angiography was 33%, 44%, and 52%, respectively. Venous sampling for an insulin assay regionalized 90% of the tumors. In 24 patients with solitary tumors, most lesions detected or missed by preoperative localization could be either seen (n= 14) or palpated (n=22). Intraoperative ultrasonography (n=17) has been routinely performed since 1987; nonpalpable tumors were imaged in 2 of 15 patients with solitary tumors. Eight solitary occult tumors were detected by palpation alone or a combination of palpation and intraoperative ultrasonography. Operative mortality occurred in 1 (3.7%) of the 27 patients, while major morbidity developed in 9 (33%) of the patients. Euglycemia was achieved in 25 patients. Surgery cured all patients with benign insulinomas, whereas the cure rate for patients with malignant neoplasms was only 33%. The type of surgical treatment or correct preoperative localization did not affect the outcome of surgery. Conclusions: Pancreatic insulinomas can be readily localized intraoperatively despite failed preoperative localization studies. Surgical treatment cured benign adenomas but was associated with notable morbidity.en_US
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_US
dc.relation.ispartofArchives of Surgeryen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshInsulinoma - Pathology - Surgeryen_US
dc.subject.meshIntraoperative Perioden_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPancreatic Neoplasms - Pathology - Surgeryen_US
dc.subject.meshPostoperative Complications - Epidemiologyen_US
dc.subject.meshPreoperative Careen_US
dc.titlePancreatic insulinomas: A 15-year experienceen_US
dc.typeArticleen_US
dc.identifier.emailKung, AWC:awckung@hku.hken_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.emailFan, ST:stfan@hku.hken_US
dc.identifier.authorityKung, AWC=rp00368en_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid9267281-
dc.identifier.scopuseid_2-s2.0-0030879086en_US
dc.identifier.hkuros28697-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030879086&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume132en_US
dc.identifier.issue8en_US
dc.identifier.spage926en_US
dc.identifier.epage930en_US
dc.identifier.isiWOS:A1997XQ29400034-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLo, CY=16417392800en_US
dc.identifier.scopusauthoridLam, KY=7403657165en_US
dc.identifier.scopusauthoridKung, AWC=7102322339en_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridTung, PHM=7006585735en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US

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