Surgical approaches in 84 patients with insulinomas in multiple endocrine neoplasia type 1 (MEN 1)

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Introduction: Management of insulinomas in the setting of Multiple Endocrine Neoplasia type 1 (MEN1) remains controversial.

Aim(s): To evaluate long-term results of various surgical approaches in the control of hypoglycemia in insulinoma-MEN 1 patients and to characterize other parameters involved in the therapeutic decision–making process (WHO status at diagnosis, post-operative morbidity, functioning and non-functioning duodenopancreatic recurrences).

Materials and methods: All 84 consecutive patients with insulinoma and MEN1 from 30 French centers of the GTE were retrospectively studied. They had clinical and biochemical diagnosis of insulinoma and MEN 1 syndrome according to the standardized definitions. Results are classified as a function of surgery: total pancreatectomy (TP), cephalic duodenopancreatectomy (CDP), splenopancreatectomy (SPC), or enucleation alone (E). Definitive cure of insulinoma was defined as absence of recurrence of symptomatic hypoglycaemia during the follow-up. Recurrences were classified in three subgroups: functioning syndrome (hypoglycemia or non-hypoglycaemia) and pancreatic tumor. Permanent postoperative adverse effects were recorded.

Conference: 7th Annual ENETSConcerence (2010)

Presenting Author: Baudin E

Authors: Vezzosi D, Cardot-Bauters C, Murat A, Bertholon-Gregoire M, Niccoli P,

Keywords: insulinoma, multiple endocrine neoplasia type 1, enucleation, cephalic duodenopancreatectomy, splenopancreatectomy, total pancreatectomy,