Insulinoma surgery: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Insulinoma}}
{{Insulinoma}}
{{CMG}}{{AE}}{{PSD}}
{{CMG}}{{AE}}{{ADS}}{{PSD}}
==Overview==
==Overview==
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
Line 8: Line 8:
Surgery is the mainstay of treatment for benign and resectable malignant insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.
Surgery is the mainstay of treatment for benign and resectable malignant insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.
===Benign Tumors===
===Benign Tumors===
*Small well-encapsulated, solitary tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
*Small well-encapsulated, solitary tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref><ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058  }} </ref>
:*Surgical resection is treatment of choice (minimal invasive surgery)
:*Surgical resection is treatment of choice (minimal invasive surgery)
::*Enucleation
::*Enucleation
Line 17: Line 17:


===Malignant Tumors===
===Malignant Tumors===
*Resectable tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref>
*Resectable tumors:<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=PMC3574879 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217  }} </ref><ref name=surgery> Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm</ref><ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058  }} </ref>
:*Aggressive surgical resection, including extended pancreatic resection, [[liver resection]], and/or [[liver transplantation]]
:*Aggressive surgical resection, including extended pancreatic resection, [[liver resection]], and/or [[liver transplantation]]
:*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia
:*Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia
Line 27: Line 27:
:*[[Embolization]]
:*[[Embolization]]
:*Intra-arterial chemotherapy
:*Intra-arterial chemotherapy
==Overview==
Surgery is the mainstay of treatment for insulinoma
==Surgery==
*Surgical intervention is not recommended for the management of [disease name].
OR
*Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
**[Indication 1]
**[Indication 2]
**[Indication 3]
*The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
*Surgery is the mainstay of treatment for [disease or malignancy].


==Indications==
==Indications==
 
* Repeated and prolonged symptoms of hypoglycemia


==References==
==References==

Revision as of 16:09, 7 September 2017

Insulinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Insulinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Insulinoma surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Insulinoma surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Insulinoma surgery

CDC on Insulinoma surgery

Insulinoma surgery in the news

Blogs on Insulinoma surgery

Directions to Hospitals Treating Insulinoma

Risk calculators and risk factors for Insulinoma surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]Parminder Dhingra, M.D. [3]

Overview

Surgery is the mainstay of treatment for insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.[1][2]

Surgery

Surgery is the mainstay of treatment for benign and resectable malignant insulinoma. The feasibility of surgery depends on the stage of insulinoma at diagnosis.

Benign Tumors

  • Small well-encapsulated, solitary tumors:[1][2][3]
  • Surgical resection is treatment of choice (minimal invasive surgery)
  • Enucleation
  • Partial pancreatectomy
  • Middle pancreatectomy
  • Multiple, unencapsulated, >4 cm in diameter, and involves or is near the main pancreatic duct:
  • Radical resection

Malignant Tumors

  • Aggressive surgical resection, including extended pancreatic resection, liver resection, and/or liver transplantation
  • Post-surgical chemoembolization or radiofrequency ablation of tumors to control hypoglycemia
  • Unresectable tumors
  • Octreotide administration
  • Continous glucose monitoring
  • Radiofrequecy ablation
  • Embolization
  • Intra-arterial chemotherapy

Indications

  • Repeated and prolonged symptoms of hypoglycemia

References

  1. 1.0 1.1 1.2 Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y; et al. (2013). "Diagnosis and management of insulinoma". World J Gastroenterol. 19 (6): 829–37. doi:10.3748/wjg.v19.i6.829. PMC 3574879. PMID 23430217.
  2. 2.0 2.1 2.2 Inulinoma. national library of medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000387.htm
  3. 3.0 3.1 Service FJ, McMahon MM, O'Brien PC, Ballard DJ (1991). "Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study". Mayo Clin Proc. 66 (7): 711–9. PMID 1677058.



Template:WikiDoc Sources