Intraoperative ultrasonography for pancreatic insulinomas.

BACKGROUND/AIMS: Islet cell adenomas of the pancreas are both single and benign tumors in more than 90% of the cases. Even with the use of increasingly innovative diagnostic techniques, a percentage of tumors are not located in the preoperative or, sometimes, even intraoperative phase. This study compares the results of various diagnostic techniques and provides a brief review of the literature.

MATERIALS AND METHODS

Between January 1978 and December 1994, 15 patients (11 females and 4 males) averaging 49 years of age (range 27-70) affected by pancreatic insulinoma underwent surgery at the Department of General Surgery of the "R. Silvestrini" Hospital.

RESULTS

In 8 cases the tumor intrapancreatic position was indicated in the preoperative stage. On the contrary, intraoperative ultrasonography allowed the correct location in all the cases, but one. Surgery allows for the complete cure from the diseases when the removal of adenoma is complete. All of our patients underwent surgery which involved enucleation or resection of the distal portion of the pancreas.

CONCLUSION

The choice of the type of operation to perform, as well as the consequential morbidity and mortality, seems to depend essentially on the size and position of the insulinoma. All of the patients, except for one who died because of a pancreatic fistula, are alive and normoglycaemic.