Insulinoma surgery: Difference between revisions

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{{CMG}}{{AE}}{{PSD}}
{{CMG}}{{AE}}{{PSD}}
==Overview==
==Overview==
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name==surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>


==Surgery==
==Surgery==
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.
===Benign Tumors===
===Benign Tumors===
*Small well-encapsulated, solitary tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref><ref> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
*Small well-encapsulated, solitary tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name==surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref><ref> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
:*Surgical resection is treatment of choice (minimal invasive surgery)
:*Surgical resection is treatment of choice (minimal invasive surgery)
::*Enucleation
::*Enucleation
Line 17: Line 17:


===Malignant Tumors===
===Malignant Tumors===
*Resectable tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
*Resectable tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name==surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
:*Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation
:*Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation
:*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia
:*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia

Revision as of 15:27, 7 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.[1][2]

Surgery

Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.

Benign Tumors

  • Small well-encapsulated, solitary tumors:[1][2][3]
  • 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

  • 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

  1. ↑ 1.0 1.1 1.2 Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y; et al. (2013). "Diagnosis and management of insulinoma". World J Gastroenterol. 19 (6): 829–37. doi:10.3748/wjg.v19.i6.829. PMC 3574879. PMID 23430217.
  2. ↑ 2.0 2.1 2.2 Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm
  3. ↑ Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm
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