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Recovery of hypoglycemia symptoms after insulinoma negative pancreatic surgery: Case series

Mehmet Aziret; Metin Ercan; Adem Senturk; Erdal Birol Bostanci; Musa Akoglu.

Abstract
Insulinoma, one of the most common endocrine tumors of the pancreas, is usually benign, solitary and has an intrapancreatic
location. Precise localization of insulinoma is important for curative treatment.
This study looks at 5 patients who underwent operation for insulinoma. The median age, body mass index, preoperative insulin and
C-peptide levels, and length of hospital stay were 36 years, 27 kg/m2, 32 μU/ml, 7ng/ml and 21 days, respectively. An endoscopic
ultrasound (EUS) and intraoperative ultrasound (I-OUS) were conducted on all of the patients. Enucleation was performed on 3
patients and distal pancreatectomy ± splenectomy on 2 patients. Furthermore, the histopathological examination conducted on the
patients showed insulinoma in 3 patients and granulomatous lymphadenitis in 1 patient, with one observed to have normal pancreas
tissues. Following the operation, the glucose level of all patients was found to be within a normal range.
Distal pancreatectomy and enucleation can only be performed after determining precise localization of insulinoma via EUS and
I-OUS.

Key words: Insulinoma;Enucleation;Distal Pancreatectomy;Endoscopic Ultrasonography (EUS);Intraoperative Ultrasonography (I-OUS)


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