Hypoglycemia surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
* Surgical removal of the insulinoma is the treatment of choice:<ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058 }}</ref> | * Surgical removal of the insulinoma is the treatment of choice:<ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058 }}</ref> | ||
**Enucleation of the insulinoma | **[[Enucleation]] of the [[insulinoma]]: just removal of the [[mass]] out of the [[pancreas]] with thin margins between tumor and [[pancreas]] | ||
**Partial distal pancreatectomy | **Partial distal [[pancreatectomy]]: in this procedure, the body and tail of the [[pancreas]] are removed. | ||
**Distal subtotal pancreatectomy is recommended for patients with insulinoma related to MEN1.<ref name="pmid1684067">{{cite journal| author=Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH| title=Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach. | journal=Surgery | year= 1991 | volume= 110 | issue= 6 | pages= 998-1004; discussion 1004-5 | pmid=1684067 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1684067 }}</ref> | **Distal subtotal [[pancreatectomy]] is recommended for patients with insulinoma related to [[MEN1]].<ref name="pmid1684067">{{cite journal| author=Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH| title=Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach. | journal=Surgery | year= 1991 | volume= 110 | issue= 6 | pages= 998-1004; discussion 1004-5 | pmid=1684067 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1684067 }}</ref> | ||
* Recurrence is more common in the patients with [[MEN1]]. | * Recurrence is more common in the patients with [[MEN1]]. | ||
* Hepatic resection is indicated for the treatment of [[metastatic]] [[Liver diseases|liver disease]] if general condition is good. Resection should be considered only for patients with a limited number of hepatic metastases. | * Hepatic resection is indicated for the treatment of [[metastatic]] [[Liver diseases|liver disease]] if the general condition is good. Resection should be considered only for patients with a limited number of hepatic metastases. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 22:16, 19 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Surgical removal of the insulinoma is the treatment of choice and resection of metastatic liver disease.
Surgery
- Surgical removal of the insulinoma is the treatment of choice:[1]
- Enucleation of the insulinoma: just removal of the mass out of the pancreas with thin margins between tumor and pancreas
- Partial distal pancreatectomy: in this procedure, the body and tail of the pancreas are removed.
- Distal subtotal pancreatectomy is recommended for patients with insulinoma related to MEN1.[2]
- Recurrence is more common in the patients with MEN1.
- Hepatic resection is indicated for the treatment of metastatic liver disease if the general condition is good. Resection should be considered only for patients with a limited number of hepatic metastases.
References
- ↑ Service FJ, McMahon MM, O'Brien PC, Ballard DJ (1991). "Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study". Mayo Clin Proc. 66 (7): 711–9. PMID 1677058.
- ↑ Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH (1991). "Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach". Surgery. 110 (6): 998–1004, discussion 1004-5. PMID 1684067.