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- W1499630403 abstract "Insulinomas are the most common functional endocrine neoplasms of the pancreas, causing recurrent episodes of fasting hypoglycemia. The classic diagnostic criteria (Whipple's triad) are present in most cases. Operative resection is the only current cure for insulinomas, performed either open or laparoscopically. Features of insulinomas that make them amenable for laparoscopic resection are their small size, their high rate of being benign (90%), and the solitary and sporadic nature of most insulinomas. For preoperative workup, computed tomography (CT), magnetic resonance imaging (MRI), and/or endoscopic ultrasonography (EUS) are performed for localization of the neoplasm(s). Intraoperative ultrasonography (IOUS) is helpful in identifying the tumor, assessing the relationship between the tumor and the pancreatic duct, and looking for other tumors. Enucleation of benign, well-circumscribed insulinomas less than 2 cm that are far from the main pancreatic duct is appropriate therapy. Segmental resection of the pancreas, distal pancreatectomy, or rarely pancreatoduodenectomy may be required for lesions close to the pancreatic duct, those involving a large portion of the pancreas, or those suspected of being malignant. Spleen-preserving distal pancreatectomy is performed when possible. Distal pancreatectomy with splenectomy is performed when neoplasms located at the splenic hilum cannot be removed safely and completely without splenic injury. Neoplasms that are hard, are infiltrating, or cause pancreatic duct dilatation should raise a suspicion of malignancy. If malignant, the tumor is resected with an oncologic resection; if metastatic, attempts to remove all primary and metastatic disease in an effort to minimize the effects of hyperinsulinism are warranted. A special group comprises patients with multiple endocrine neoplasia type 1 syndrome (MEN-1). Insulinoma affects approximately 5%–10% of MEN-1 patients, and the MEN-1–associated insulinomas tend to be multifocal and have a greater risk of being malignant." @default.
- W1499630403 created "2016-06-24" @default.
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- W1499630403 date "2015-03-31" @default.
- W1499630403 modified "2023-10-14" @default.
- W1499630403 title "Insulinoma: Evidence of Surgical Treatment" @default.
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- W1499630403 doi "https://doi.org/10.1002/9781118307816.ch44" @default.
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