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2015 | 86 | 11 | 505-510
Tytuł artykułu

Insulinoma - Rare, But Important Clinical Problem. Analysis of a Series of 530 Patients Who Underwent Surgical Treatment for the Pancreatic Tumor

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Insulinomas are rare tumors, accounting for 1-2% of all neoplasms of the pancreas. Usually their treatment is not associated with any problems; however there is a small subset of problematic clinical cases. The authors present their own clinical experience with surgical treatment of insulinomas of the pancreas. The aim of the study was to conduct a retrospective analysis of patients with insulinomas of the pancreas who underwent surgical treatment at Department of General and Transplant Surgery Medical University in Łódź. Material and methods. The study included all patients who underwent surgical treatment at the Department between 2007 and 2013 for the tumor of the pancreas. Further retrospective analysis included all patients with tumors of the insulinoma type. The data was obtained from medical records, surgical protocols and histopathology reports. Results. The analysis included 530 patients who underwent surgical treatment for the tumor of the pancreas. Insulinoma was found in 10 (1.88%) patients (8 females, 2 males). An average age of patients who underwent surgical treatment was 47.5±13.8 years. An average size of the tumor was 1.6±0.5 cm. Six patients underwent extirpation of the insulinoma, while the other patients underwent distal resection of the pancreas. All patients underwent “an open surgical procedure”. The average duration of the surgical procedure was 55±45 minutes. Duration of the hospitalization in the analyzed group of patients was 7±5 days. Incidence of postoperative pancreatic fistulas was 10%. All insulinomas were benign. Conclusions. Insulinomas were rare among patients who underwent surgical treatment at the Department. They were benign and their treatment was unproblematic. However, there is a small group of cases that can be associated with problematic clinical situations. Thus treatment of patients with insulinomas should be conducted at specialist centers. Correct diagnostic and therapeutic management, involving close cooperation between multiple medical specialists, results in complete curing of majority of patients.
Słowa kluczowe
Wydawca

Rocznik
Tom
86
Numer
11
Strony
505-510
Opis fizyczny
Daty
otrzymano
2014-10-06
online
2015-02-03
Twórcy
  • Department of General and Transplant Surgery, Medical University in Łódź Kierownik: prof. dr hab.
  • Department of General and Transplant Surgery, Medical University in Łódź Kierownik: prof. dr hab.
  • Department of General and Transplant Surgery, Medical University in Łódź Kierownik: prof. dr hab., durek@retsat1.com.pl
  • Department of General and Transplant Surgery, Medical University in Łódź Kierownik: prof. dr hab.
  • Department of Digestive Tract Diseases, Medical University in Łódź Kierownik: prof. dr hab.
  • Department of Digestive Tract Diseases, Medical University in Łódź Kierownik: prof. dr hab.
  • Department of General and Transplant Surgery, Medical University in Łódź Kierownik: prof. dr hab.
Bibliografia
  • 1. Service FJ, McMahon MM, O'Brien PC et al.: Functioning insulinomas-incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc 1991; 66(7): 711-19.[Crossref]
  • 2. Czupryniak L, Strzelczyk J, Drzewoski J: Diagnostic difficulties in long-standing insulinoma with near-normal plasma insulin levels. J Endocrinol Invest 2005; 28(2): 170-74.[Crossref][PubMed]
  • 3. Sotoudehmanesh R, Hedayat A, Shirazian N et al.: Endoscopic ultrasonography (EUS) in the localization of insulinoma. Endocrine 2007; 31: 238-41.[WoS]
  • 4. Finlayson E, Clark OH: Surgical treatment of insulinomas. Surg Clin N Am 2004; 84: 775-85.
  • 5. Gama R, Teale JD, Marks V: Best practice No 173: clinical and laboratory investigation of adult spontaneous hypoglycaemia. J Clin Pathol 2003; 56: 641-46.
  • 6. Bright E, Garcea g, Ong SL et al.: An unusual case of concurrent insulinoma and nesidioblastosis. JOP 2008; 9(5): 649-53.
  • 7. Mansour Jc, Chen H: Pancreatic endocrine tumors. J Surg Res 2004; 120: 139-161.
  • 8. Mittendorf EA, Liu Yc, McHenry CRL: Giant insulinoma: case report and review of the literature. J Clin Endocrinol Metab 2005; 90: 575-80.
  • 9. Kann PH, Rothmund M, Zielke A: Endoscopic ultrasound imaging of insulinomas: limitations and clinical relevance. Exp Clin Endocrinol Diabetes 2005; 113: 471-74.
  • 10. Hiramoto Js, Feldstein VA, LaBerge JM et al.: Intraoperative ultrasound and preoperative localization detects all occult insulinomas. Arch Surg 2001; 136(9): 1020-25.
  • 11. Rothmund M, Angelini L, Brunt M et al.: Surgery for benign insulinomas: an international review. World J Surg 990; 14(3): 393-98.
  • 12. Szymański D, Durczyński A, Nowicki M et al.: Gastrojejunostomy in patients with unresectable pancreatic head cancer - the use of Roux loop significantly shortens the hospital length of stay. World J Gastroenterol 2013; 19(45): 8321-25.[WoS][Crossref]
  • 13. Durczyński A, Kumor A, Hogendorf P et al.: D-dimers Revisited: A New Marker of Pancreatic Cancer. Am J Clin Oncol 2014 Mar 21. (Epub ahead of print)
  • 14. Durczyński A, szymański D, Nowicki M et al.: Very high concentration of D-dimers in portal blood in patients with pancreatic cancer. Pol Przegl chir 2012; 84(10): 521-25.
  • 15. Durczyński A, Wiszniewski M, olejniczak W et al.: Asymptomatic solid pancreatic hamartoma. Arch Med sci 2011; 7(6): 1082-84.[Crossref][WoS]
  • 16. carneiro DM, Levi JÜ, irvin Gl: Rapid insulin assay for intraoperative confirmation of complete resection of insulinomas. surgery 2002; 132(6): 937-42.
  • 17. Hirshberg В, Libutti SK, Alexander HR et al.: Blind distal pancreatectomy for occult insulinoma, an inadvisable procedure. J Am Coll Surg 2002; 194: 761-64.
  • 18. Osullivan SS, Redmond J: Response: Insulinoma presenting as refractory late-onset epilepsy. Epilepsia 2005, 46, 1690-91.[Crossref]
  • 19. Graves TD, Gandhi S, Smith SJ et al.: Misdiagnosis of seizures, insulinoma presenting as adult-onset seizure disorder. J Neurol Neurosurg Psychiatry 2004, 75, 1091-92.
  • 20. Ríccí C, Casadei R, Buscemi S et al.: Laparoscopic distal pancreatectomy: what factors are related to the learning curve? Surg Today 2014 Mar 9. (Epub ahead of print)[WoS]
  • 21. Al-kurd A, Chapchay K, Grozinsky-glasberg S et al.: Laparoscopic resection of pancreatic neuroendocrine tumors. World J Gastroenterol 2014; 20(17): 4908-16.[Crossref]
  • 22. Drymousis P, Raptis DA, Spalding D: Laparoscopic versus open pancreas resection for pancreatic neuroendocrine tumours: a systematic review and meta-analysis. HPB (oxford) 2014; 16(5): 397-406.[PubMed]
  • 23. Mehrabi A, Fischer L, Hafezi M et al.: A systematic review of localization, surgical treatment options, and outcome of insulinoma. Pancreas 2014; 43(5): 675-86.[Crossref]
  • 24. Lo CY, Lo CM, Lo S et al.: Role of laparoscopic ultrasonography in intraoperative localization of pancreatic insulinoma. Surg Endosc 2000; 14(12): 1131-35.[Crossref]
  • 25. Baudin E, Caron P, Lombard-Bohas C et al.: Malignant insulinoma: Recommendations for wor-kup and treatment. Presse Med 2014; 43(6 Pt 1): 645-59.[Crossref][WoS]
  • 26. Okabayashi T, Shima Y, Sumiyoshi T et al.: Diagnosis and management of insulinoma. World J Gastroenterol 2013; 19(6): 829-37.[Crossref][WoS]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2014-0090
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