Surgical Treatment for Insulinoma: a Study of 6 Cases

The authors treated six patients with insulinoma in our department during a period up to 1984, and performed seven operations including one re-operation. In this paper, the results of our study of the clinical symptoms, diagnosis and surgical formula in these cases are presented. Selective angiography and percutaneous transhepatic portal venous sampling (PTPVS) proved useful for pre-operative tumor localization diagnosis. Blood glucose monitoring during operation became a good index for the selection of the surgical formula. In the cases of surfacial and single tumors, enucleation alone was able to obtain satisfactory surgical results. In the cases, however, when re-operative, deep or multiple tumors were suspected, staged distal pancreatectomy under blood glucose monitoring was considered to be indicated. It was therefore thought that the preservation of the pancreas should be made as far as possible.