Diagnosis And Surgical Treatment Of Insulinoma In 23 Cases

Objective To review the methods used for diagnosis and surgical treatment of insulinoma. Methods We analyzed retrospectively 23 cases of insulinoma from 1998 to 2005.Results Of the 23 cases,19 had typical Whipple's triad. The sensitivity of the disease was 47.8% (11/23) to ultrasonography , 64.7%(11/17) to CT , 85.7%(6/7)to selective arteriography. Simple enucleation was performed in 14 cases,local resection of pancrease in 6,resection of pancreatic body and tail in 1 ,Whipple in 1 and tumor enucleation through laparoscope in 1.After operation,blood glucose became normal in all cases,but pancreatic leak occurs in 4 cases and pseudocyst in 1, psychiatric symptom in 2 cases have no improvement. Conclusions Whipple's Triad and IRI/G>0.3 have significance to diagnose insulinoma.Ultrasonography,CT and selective arteriography are used for localization diagnosis. Simple enucleation is the most common surgical method. The application of Intraoperative ultrasonography and blood glucose monitoring show great significance.