SURGICAL TREATMENT OF INSULINOMA

Authors

  • Boyko V. V. State Institution «Zaycev V.T. Institute of general and urgent surgery», Kharkiv, Ukraine; 2 Kharkiv national medical university, Kharkiv, Ukraine
  • Smachylo R. M. State Institution «Zaycev V.T. Institute of general and urgent surgery», Kharkiv, Ukraine
  • Chernyayev M. S. Kharkiv national medical university, Kharkiv, Ukraine
  • Pesotsky O. M. Kharkiv City Clinical Emergency and Immediate Medical Care Hospital named by prof. A. I. Meschaninov», Kharkiv, Ukraine
  • Remnyova N. O. V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
  • Mushenko E. V. State Institution «Zaycev V.T. Institute of general and urgent surgery», Kharkiv, Ukraine
  • Protsenko O. S. V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
  • Zharov O. V. State Institution «Zaycev V.T. Institute of general and urgent surgery», Kharkiv, Ukraine; 2 Kharkiv national medical university, Kharkiv, Ukraine

DOI:

https://doi.org/10.21856/j-PEP.2020.4.02

Keywords:

Insulinoma; hyperinsulinemia, resection of pancreas, neuroendocrine pancreatic tumor

Abstract

Insulinoma is a neuroendocrine tumor, most often presented as a solitary neoplasm of the pancreas, manifested
by hypoglycemia caused by increased insulin secretion. Insulinoma can occur at any age and can be localized
in any part of the pancreas. Despite the significant improvement in diagnostic capabilities in recent years,
there is still a problem of late diagnosis of insulinoma. This article provides a retrospective analysis of the
results of treatment of patients with insulinoma in 2000–2019; analyzed modern methods of diagnosis and surgical
treatment of patients with insulinoma; the tactics of surgical treatment of patients with insulinomas was
optimized, depending on the location and size of the tumor. The basis of clinical and laboratory diagnostics of insulinoma
is the identification of the patient's criteria for the Whipple triad, elevated levels of insulin, proinsulin
and C-peptide with a decrease in blood glucose levels, as well as a 72-hour fasting test. The main instrumental
techniques are ultrasound, MRI and CT scan with intravenous contrast. The method of choice in the treatment
of the majority of patients with insulinomas is surgical. Enucleation of insulinoma is the operation of choice for
superficial localization in the head and body of the pancreas with small tumor sizes. In case of localization of
insulinoma in the tail area, deep localization, a diameter of more than 2.5 cm, close proximity to the ducts and
/ or splenic vessels, suspicion of a malignant process (in the body or tail), it is necessary to give preference to
distal resection of the pancreas with insulinoma. With a deep location in the head of the pancreas and if there
is a connection with the duct system, it is necessary to perform pancreatoduodenal resection. Moreover, radical
surgical treatment can be performed in most patients and has relatively good long-term results.

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Published

2021-06-30

How to Cite

Boyko, V. V., Smachylo, R. M., Chernyayev, M. S., Pesotsky, O. M., Remnyova, N. O., Mushenko, E. V., Protsenko , O. S., & Zharov, O. V. (2021). SURGICAL TREATMENT OF INSULINOMA. Problems of Endocrine Pathology, 74(4), 15-25. https://doi.org/10.21856/j-PEP.2020.4.02

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Section

CLINICAL ENDOCRINOLOGY