Chronologic Change of Hyperinsulinemic Hypoglycemic Disease-insulinoma and Nesidioblastosis in 64 Patients
Korean Journal of Hepato-Biliary-Pancreatic Surgery
;
: 275-285, 2009.
Artículo
en Coreano
| WPRIM
| ID: wpr-140589
ABSTRACT
PURPOSE:
Insulinomas and nesidioblastosis are surgically curarable hyperinsulinemic hypoglycemic diseases; however the symptoms, diagnosis, and localization of these diseases are sometimes difficult.METHODS:
From April 1990 to December 2008, patients with diagnosis of pancreatic insulinoma and nesidioblastosis were retrospectively reviewed.RESULTS:
In the entire cohort, there were 6 patients with multiple endocrine neoplasia type 1 (MEN 1), 7 patients with nesidioblastosis, and 7 patients with multiple lesions. The incidence of neuroglycopenic symptoms (71.5%) was more prevalent than autonomic symptoms (26.5%). The pre-operative localization methods were computed tomography (CT), transabdominal ultrasonography, endoscopic ultrasonography (EUS), magnetic resonance imaging (MRI), angiography, selective arterial calcium stimulation with venous sampling (ASVS), and transhepatic portal venous sampling (THPVS) which had sensitivities of 75%, 40%, 75%, 64%, 48%, 20%, and 87%, respectively. During the second half of the study period, CT had a sensitivity of 83%. THPVS was the most sensitive method of all the diagnostic tools. Intra-operative palpation and ultrasonography were the most powerful modalities for tumor localization. The surgical treatments included enucleation (20%), distal pancreatectomy (51%), central pancreatectomy (12%), pancreaticoduodenectomy (15%), and near-total pancreatectomy (1.5%). From 2006, laparascopic surgery was used as the preferred treatment modality for insulinomas.CONCLUSION:
Early diagnosis and precise localization is the most important aspect of treating insulinomas. For better localization, dual phase spiral CT and intra-operative ultrasonography play an important role in tumor localization.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Palpación
/
Pancreatectomía
/
Imagen por Resonancia Magnética
/
Angiografía
/
Calcio
/
Incidencia
/
Estudios Retrospectivos
/
Estudios de Cohortes
/
Pancreaticoduodenectomía
/
Neoplasia Endocrina Múltiple Tipo 1
Tipo de estudio:
Estudio diagnóstico
/
Estudio de etiología
/
Estudio de incidencia
/
Estudio observacional
/
Estudio pronóstico
/
Estudio de tamizaje
Límite:
Humanos
Idioma:
Coreano
Revista:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Año:
2009
Tipo del documento:
Artículo
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