Combined use of calcium infusion localization and a minimally invasive surgical procedure in the management of insulinoma.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
L Raymond ReynoldsDennis G Karounos

Abstract

To review our experience with current diagnostic localization techniques and a minimally invasive laparoscopic surgical procedure in the management of insulinoma. We describe five patients with insulinoma, the results of diagnostic studies, and a proposed algorithm for management of this rare tumor. Four female patients and one male patient (age range, 34 to 72 years) underwent supervised fasting (mean duration, 12 hours; range, 3 to 28 hours) to establish the diagnosis of insulinoma. These patients had glucose values that ranged from 38 to 41 mg/dL and associated serum insulin levels of 11.3 to 61 microU/mL. C-peptide values ranged from 3.4 to 11.5 ng/mL, and proinsulin levels (measured in four patients) were 32.9 to 82 pmol/L. These biochemical findings were diagnostic for insulin-mediated hypoglycemia, and the high proinsulin and C-peptide levels, in conjunction with negative results of serum measurements for sulfonylureas, excluded an exogenous source of insulin as the cause of hypoglycemia. Four of the five study patients had nondiagnostic results of noninvasive localization studies and underwent selective arterial injection of calcium with hepatic venous sampling to help localize the insulinomas within the pancreas. This ...Continue Reading

References

Jul 5, 1992·The New England Journal of Medicine·T RöschV Schusdziarra
Apr 27, 1995·The New England Journal of Medicine·F J Service
Feb 1, 1993·American Journal of Surgery·F MenegauxJ P Chigot
Aug 1, 1997·Archives of Surgery·C Y LoS T Fan
Jan 1, 1997·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M Gagner, A Pomp
Apr 16, 1999·American Journal of Surgery·A ParkM Anvari
May 11, 1999·Annals of Surgery·K D LillemoeC J Yeo
Aug 12, 1999·Archives of Surgery·M P BoukhmanO H Clark
Sep 29, 1999·Endocrinology and Metabolism Clinics of North America·F J Service
Oct 16, 1999·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·R CollinsL Roust
Aug 31, 2000·Surgery·F J BerendsH J Bonjer
Sep 22, 2000·The Journal of Clinical Endocrinology and Metabolism·B HirshbergP Gorden
Nov 30, 2000·The Journal of Clinical Endocrinology and Metabolism·F J Service, N Natt
Feb 7, 2001·The Journal of Clinical Endocrinology and Metabolism·B HirshbergP Gorden
Aug 10, 2002·Annals of Surgery·Adrian E Park, B Todd Heniford

❮ Previous
Next ❯

Citations

Dec 25, 2007·Annals of Surgery·Mehrdad NikfarjamCarlos Fernández-del Castillo
Oct 22, 2008·Annales d'endocrinologie·S Ketari-JamoussiL Rokbani
Feb 5, 2011·World Journal of Surgery·Melanie L RichardsClive S Grant

❮ Previous
Next ❯

Related Concepts

Related Feeds

Adenoma, Islet Cell

Islet Cell Adenoma arises in the islet cells, which are insulin producing cells of the pancreas. These tumors can be either malignant or benign. Discover the latest research on Islet Cell Adenoma here.