Introduction: For the last 20 years, 235 patients with the diagnosis of organic hyperinsulinismus were treated in Burdenko Surgery Clinic.
Aim(s): To improve diagnostic approach and management of patients with insulinomas.
Materials and methods: For the last 20 years, 235 patients with the diagnosis of organic hyperinsulinismus were treated in Burdenko Surgery Clinic, and 223 of them were operated on. The incidence of malignant insulinomas was 14% (33 patients) and 12 patients already had hepatic metastases at the time of diagnosis. In 14 cases (6%), nesidioblastosis without any solid pancreatic lesions was diagnosed. MEN-1 syndrome occurred in 13% (30 patients) among patient with insulinomas, however this rate quickly increased due to MEN screening in our clinic. During the last three years, it increased to 40% (14 patients). For patients with insulinoma, we used the following procedures: fasting test, transabdominal US (sensitivity 64%), endoscopic US (sensitivity 87%), CT (sensitivity 68%), arterial stimulated blood sampling test (sensitivity 95%), intraoperative US (sensitivity of 98%). We performed the following operations: enucleation of insulinoma - 127; distal pancreatic resection - 82; distal subtotal resection of pancreas - 4; gastropancreatoduodenal resection - 2. Diagnostic laparotomy was made in nine cases.
Conference: 7th Annual ENETS Conference (2010)
Presenting Author: Prof Alexey Egorov
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