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Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience

Background and Objectives: Insulinoma is a rare tumor of the Langerhans islets of the pancreas. It produces insulin and causes severe hypoglycemia with neuroglycopenic symptoms. The incidence is low, at about 1–2 per 1 million inhabitants per year. The diagnosis is based on the presence of Whipple’s...

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Autores principales: Hoskovec, David, Krška, Zdeněk, Škrha, Jan, Klobušický, Pavol, Dytrych, Petr
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456644/
https://www.ncbi.nlm.nih.gov/pubmed/37629713
http://dx.doi.org/10.3390/medicina59081423
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author Hoskovec, David
Krška, Zdeněk
Škrha, Jan
Klobušický, Pavol
Dytrych, Petr
author_facet Hoskovec, David
Krška, Zdeněk
Škrha, Jan
Klobušický, Pavol
Dytrych, Petr
author_sort Hoskovec, David
collection PubMed
description Background and Objectives: Insulinoma is a rare tumor of the Langerhans islets of the pancreas. It produces insulin and causes severe hypoglycemia with neuroglycopenic symptoms. The incidence is low, at about 1–2 per 1 million inhabitants per year. The diagnosis is based on the presence of Whipple’s triad and the result of a fasting test. Surgery is the treatment of choice. Objectives: A retrospective observational study of patients operated on for insulinoma in our hospital focused on the diagnosis, the type of surgery, and complications. Materials and Methods: We retrospectively reviewed patients operated on due to insulinoma. There were 116 surgeries between 2000 and 2022. There were 79 females and 37 males in this group. A fasting test and a CT examination were performed on all the patients. Results: The average duration of the fasting test was 18 h. Insulinoma was found in the body and tail of the pancreas in more than half of the patients. Enucleation was the most frequent type of surgery. Complications that were Clavien Dindo grade III or more occurred in 18% of the patients. The most frequent complications were abscesses and pancreatic fistula. Five patients had malignant insulinoma. Conclusions: Surgery is the treatment of choice in the case of insulinomas. The enucleation of the tumor is a sufficient treatment for benign insulinomas, which are not in contact with the main pancreatic duct. Due to the low incidence of the condition, the centralization of patients is recommended.
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spelling pubmed-104566442023-08-26 Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience Hoskovec, David Krška, Zdeněk Škrha, Jan Klobušický, Pavol Dytrych, Petr Medicina (Kaunas) Article Background and Objectives: Insulinoma is a rare tumor of the Langerhans islets of the pancreas. It produces insulin and causes severe hypoglycemia with neuroglycopenic symptoms. The incidence is low, at about 1–2 per 1 million inhabitants per year. The diagnosis is based on the presence of Whipple’s triad and the result of a fasting test. Surgery is the treatment of choice. Objectives: A retrospective observational study of patients operated on for insulinoma in our hospital focused on the diagnosis, the type of surgery, and complications. Materials and Methods: We retrospectively reviewed patients operated on due to insulinoma. There were 116 surgeries between 2000 and 2022. There were 79 females and 37 males in this group. A fasting test and a CT examination were performed on all the patients. Results: The average duration of the fasting test was 18 h. Insulinoma was found in the body and tail of the pancreas in more than half of the patients. Enucleation was the most frequent type of surgery. Complications that were Clavien Dindo grade III or more occurred in 18% of the patients. The most frequent complications were abscesses and pancreatic fistula. Five patients had malignant insulinoma. Conclusions: Surgery is the treatment of choice in the case of insulinomas. The enucleation of the tumor is a sufficient treatment for benign insulinomas, which are not in contact with the main pancreatic duct. Due to the low incidence of the condition, the centralization of patients is recommended. MDPI 2023-08-04 /pmc/articles/PMC10456644/ /pubmed/37629713 http://dx.doi.org/10.3390/medicina59081423 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hoskovec, David
Krška, Zdeněk
Škrha, Jan
Klobušický, Pavol
Dytrych, Petr
Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title_full Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title_fullStr Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title_full_unstemmed Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title_short Diagnosis and Surgical Management of Insulinomas—A 23-Year Single-Center Experience
title_sort diagnosis and surgical management of insulinomas—a 23-year single-center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456644/
https://www.ncbi.nlm.nih.gov/pubmed/37629713
http://dx.doi.org/10.3390/medicina59081423
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