Surgical management of insulinomas in 87 consecutive patients

Background: Insulinoma is rare pancreatic tumor. Incidence s 0,05 – 0,1 / 100.000 inhabitants /year. Incidence is higher in women than men (4 : 1). Surgery is causal treatment in cases of solitary tumors. Methods: We have operated on 87 patient’s suffering from hyperinsulinism between 2000 – 2016. The localization was most often in the body of the pancreas (29 %) and in the head (19 %). Proper localization of the insulinoma was unsuccessful in 8 cases (9 %) and we did not find the tumor neither preoperatively nor intraoperatively. Results: Simple enucleation of the tumor was performed in 60 % patients. Left side resection was the second one most used surgical approach. Intraoperative palpation and ultrasound by an experienced surgeon can effectively solve uncertain preoperative tumor localization. Postoperative complications occurred in 19 %. Most often it was subphrenic abscess and pancreatic fistula. Four patients were reopareted on after unsuccessful first surgery and in three of them after left resection were insulinoma found in the specimen. Patient after successful enucleation or resection are healed and without any further treatment. Conclusion: Surgery is the only potentially curative treatment option. Proper localization of the tumor is the key point for successful surgical treatment. Supported by RVO VFN 64165