Manejo Quirúrgico del lnsulinoma

Abstract

We present our experience in the treatment of insulinomas from 1975 to 1998, having operated 1 O patients with clinical
diagnosis of insulinoma. In 8 of them was founded the insulinoma tumor. One patient hada carcinoma of islet cells and the other
one hada glandular hyperplasia. From the insulinomas' group, one patient it had in the head of the pancreas, requiring proximal
pancreatoduodenectomy; 4 patients in the tail,requiring distal pancreatectomy with spenectomy and 3 in the body with
enucleation only. Ali the patients did very well, and did not have anymore clynical hypoglicemia. The patient with cancer has
been followed for 7 years; at present, free of disease and the patient with hyperplasia improved di nically. Surgical resection with
the pancreas/spleen preservation (enucleation) is the treatment of choice; however, the surgeon must be able to practice the
different pan crea tic resections in accordance with the insulinoma Iocation, as well as offer, at present, the laparoscopic resection
asan advanced alternative in accordance with his training. The lnternist and the Gastroenterologist must have special care with
patients that have evident signs of hypoglicemia, specially whose present neurologic-psychiatric symptoms in order to avoid
irreversible, cerebral damage, doing blood sugar leve! as well as insulin and peptid C in order to diagnose the insulinoma.