Insulinoma surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
The definitive management is surgical removal of the insulinoma. This may involve removing part of the pancreas as well ([[Whipple procedure]] and distal [[pancreatectomy]]). | The definitive management is surgical removal of the insulinoma. This may involve removing part of the pancreas as well ([[Whipple procedure]] and distal [[pancreatectomy]]). | ||
===Benign Tumors=== | ===Benign Tumors=== | ||
*90% | *90% | ||
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::*Enucleation | ::*Enucleation | ||
::*Partial pancreatectomy | ::*Partial pancreatectomy | ||
::*Middle pancreatectomy | ::*Middle pancreatectomy | ||
*Multiple, unencapsulated, >4 cm in diameter, and involves or is near the main pancreatic duct: | *Multiple, unencapsulated, >4 cm in diameter, and involves or is near the main pancreatic duct: | ||
:*Radical resection | :*Radical resection | ||
| Line 23: | Line 18: | ||
===Malignant Tumors=== | ===Malignant Tumors=== | ||
*10% | *10% | ||
*Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation | *Resectable tumors: | ||
*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia | :*Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation | ||
:*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia | |||
*Unresectable tumors | |||
:*Octreotide administration | |||
:*Continous glucose monitoring | |||
:*Radiofrequecy ablation | |||
:*Embolization | |||
:*Intra-arterial chemotherapy | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 15:12, 7 October 2015
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Insulinoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Insulinoma surgery On the Web |
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American Roentgen Ray Society Images of Insulinoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
Surgery
The definitive management is surgical removal of the insulinoma. This may involve removing part of the pancreas as well (Whipple procedure and distal pancreatectomy).
Benign Tumors
- 90%
- Small well-encapsulated, solitary tumors:
- Surgical resection is treatment of choice (minimal invasive surgery)
- Enucleation
- Partial pancreatectomy
- Middle pancreatectomy
- Multiple, unencapsulated, >4 cm in diameter, and involves or is near the main pancreatic duct:
- Radical resection
Malignant Tumors
- 10%
- Resectable tumors:
- Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation
- Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia
- Unresectable tumors
- Octreotide administration
- Continous glucose monitoring
- Radiofrequecy ablation
- Embolization
- Intra-arterial chemotherapy