Laparoscopic surgical treatment of insulinomas with the use of intraoperative ultrasonography

Abstract

Background - Insulinoma are insulin productive tumors originated from the pancreatic beta cells with an incidence of 4/1 million persons. It is more prevalent between the 5th and 6th decade, in women (2:1) and from the endocrine pancreatic tumor is the more frequent (50% to 60%). Insulinoma behave as a benign tumor when the diameter is inferior to 2 cm. The diagnosis is mainly clinical and laboratorial. Surgery is the unique treatment with potential cure. Aim - The present observation reports the use of simultaneous laparoscopic resection associated to intraoperative ultrasonography. Methods - Five patients were studied (3 man and 2 women) with age from 20 to 53 years old, clinically diagnosed with insulinoma. After image work out it was proposed nuclear resection of the insulinoma by laparoscopic technique associated to intraoperative ultrasonography. Results - The patients had a complete remission of tumor related hypoglycemia and one patient developed a pancreatic fistula and other a pancreatic pseudocist with good postoperative resolution. Conclusions - The videolaparoscopic approach for the surgical treatment of insulinoma is feasible. The intraoperative ultrasonography helps to identify the lesions and check their complete resection with low complication rate.