The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2024;46(3):263-269. doi: 10.7888/juoeh.46.263.
Surgery is the main treatment for insulinoma, and precise preoperative localization is important to determine the extent of resection and to rule out multiple lesions. The selective arterial calcium injection (SACI) test is instrumental in the localization of insulinoma. Here we report a patient in whom the exact location of pancreatic insulinoma could not be determined by the conventional SACI test, and thus surgery was replaced with oral diazoxide. The hyperselective SACI test subsequently localized the lesion accurately, allowing surgical resection of the pancreatic body and tail while preserving the pancreatic head. We recommend the use of the hyperselective SACI test when the conventional SACI test fails to accurately determine the location of insulinoma lesions within the pancreas.
手术是胰岛素瘤的主要治疗方法，精确的术前定位对于确定切除范围和排除多发病灶非常重要。选择性动脉钙注射（SACI）试验有助于胰岛素瘤的定位。本文报告了一例患者，常规 SACI 试验无法确定其胰腺胰岛素瘤的确切位置，因此手术被奥曲肽取代。随后进行的高选择性 SACI 试验准确地定位了病变，使胰体和胰尾得以切除，同时保留了胰头。当常规 SACI 试验不能准确确定胰腺内胰岛素瘤病灶的位置时，我们建议使用高选择性 SACI 试验。
