Preoperative Localisation and Surgical Management of Insulinoma: Single Centre Experience

被引:16
作者
Varma, Vibha [1 ]
Tariciotti, Laura [1 ]
Coldham, Christopher
Taniere, Phillipe [2 ]
Buckels, John A. [1 ]
Bramhall, Simon R. [1 ]
机构
[1] Univ Hosp Birmingham NHS Fdn Trust, Liver Unit, Queen Elizabeth Hosp, Birmingham B15 2TH, W Midlands, England
[2] Univ Hosp Birmingham NHS Fdn Trust, Dept Cellular Pathol, Queen Elizabeth Hosp, Birmingham B15 2TH, W Midlands, England
关键词
Insulinoma; Preoperative localisation; Malignant insulinoma; Enucleation; Neuroendocrine tumour; PANCREATIC NEUROENDOCRINE TUMORS; ISLET-CELL TUMORS; INTRAOPERATIVE ULTRASOUND; OCCULT INSULINOMA; ENDOCRINE TUMORS; SURVIVAL; RESECTION; CT; STRATEGY; SURGERY;
D O I
10.1159/000322405
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: The majority of insulinomas are benign, small and intrapancreatic. Preoperative localisation is important to plan the surgical management. Methods: We retrospectively analysed our data on the preoperative imaging, type of surgery and histopathological features of the operated patients with an insulinoma from January 1993 to March 2010. Univariate and multivariate analyses were performed to detect the predictive factors for survival following surgery. Results: Forty patients were operated on for insulinoma, of which 33 were benign and 7 were malignant. The sensitivity of preoperative computed tomogram scan, magnetic resonance imaging and endoscopic ultrasound, for localising the lesions was 62, 82 and 94%, respectively. Enucleation was performed in 21 (52.5%) patients, and remaining had pancreatic resection. Hepatic resection was performed in 2 and liver transplantation in 1 patient. Morbidity and perioperative mortality was 17 (42.5%) and 1 (2.7%), respectively. The overall 5- and 10-year survival was 89 and 86.5%, respectively. The presence of metastases was found to be an independent predictor of poor survival on multivariate analysis. Conclusion: Preoperative computed tomogram/magnetic resonance imaging and endoscopic ultrasound are sensitive in localizing the majority of insulinomas. Surgery offers a good long-term survival, even in patients with malignant insulinoma. Copyright (C) 2011 S. Karger AG, Basel
引用
收藏
页码:63 / 73
页数:11
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