Article

World Journal of Surgery

, Volume 26, Issue 10, pp 1297-1300

Videolaparoscopic Resection of Insulinomas: Experience in Two Institutions

  • Luis Gramática, Jr.Affiliated withDepartment of Surgery, Clínica Sucre
  • , Miguel F. HerreraAffiliated withDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
  • , Andrés Mercado-LunaAffiliated withDepartment of Surgery, Clínica Sucre
  • , Mauricio SierraAffiliated withDepartment of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
  • , Guillermo VerasayAffiliated withDepartment of Surgery, Clínica Sucre
  • , Noemí BrunnerAffiliated withDepartment of Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

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Abstract

Laparoscopic resection of islet cell tumors has been performed in some selected cases. The aim of the study was to analyze the experience of two institutions in the laparoscopic management of insulinomas. In a 4-year period, videolaparoscopic resection of sporadic insulinomas was performed in 9 patients. All patients had hypoglycemia/hyperinsulinism and a solitary tumor demonstrated by image studies. Demographics, surgical findings, results, and complications were analyzed. Mean age of the patients was 43 years. One patient was male and eight were females. One tumor was located in the head of the pancreas, 4 in the body, and 4 in the tail. Laparoscopic resection was completed in all patients. Procedures included 4 enucleations and 5 distal pancreatectomies. Pancreatic resection with splenic preservation was achieved in 4 cases. Intraoperative ultrasound was used in 7 patients. Mean size of the tumors was 1.6 cm. All patients became normoglycemic after surgery. Complications included one pancreatic fistula, one pleural effusion, and one peripancreatic fluid collection. All resolved spontaneously. In a follow-up period between 3 and 48 months no evidence of recurrence has been observed. This series supports laparoscopic resection of preoperatively localized benign solitary insulinomas. The operation provides the advantages of minimally invasive surgery and can be safely performed in most cases.