Leelasinjaroen Pornchai, Manatsathit Wuttiporn, Berri Richard, Barawi Mohammed, Gress Frank G
Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
World J Gastrointest Endosc. 2014 Oct 16;6(10):506-9. doi: 10.4253/wjge.v6.i10.506.
Although insulinomas are rare, they are the most common pancreatic neuroendocrine tumor, with an incidence of four cases per million population. Insulinomas are generally benign indolent intrapancreatic tumors. Surgical resection remains the main option for treatment. However, up to 67% of a pancreatic head insulinomas are nonpalpable, thus surgical resection of the nonplapable insulinoma in this area could become problematic resulting in prolonged surgical time, increased risk of pancreatic duct injury and need for pancreaticoduodenectomy. Endoscopic ultrasound-guided fine- needle tattooing (EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating laparoscopic distal pancreatectomy and helping surgeons identify the location of the tumor. EUS-FNT might have a role for preoperative localization of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surgical resection, reduce operative time and decrease surgical complications.
尽管胰岛素瘤很罕见，但它们是最常见的胰腺神经内分泌肿瘤，每百万人口中的发病率为4例。胰岛素瘤通常是胰腺内的良性惰性肿瘤。手术切除仍然是主要的治疗选择。然而，高达67%的胰头胰岛素瘤无法触及，因此在该区域对无法触及的胰岛素瘤进行手术切除可能会出现问题，导致手术时间延长、胰管损伤风险增加以及需要进行胰十二指肠切除术。内镜超声引导下细针纹身（EUS-FNT）已被证明在胰腺体尾部病变的定位中起着关键作用，有助于腹腔镜远端胰腺切除术，并帮助外科医生确定肿瘤的位置。EUS-FNT可能在术前定位可能无法触及的胰头胰岛素瘤方面发挥作用。我们报告了一例术前使用EUS-FNT定位无法触及的胰头胰岛素瘤的病例。本报告表明，胰头胰岛素瘤的EUS-FNT可能有助于手术切除，减少手术时间并降低手术并发症。
