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Pancreatic insulinoma:current issues and trends

Hepatobiliary & Pancreatic Diseases International 2010年第3期9卷 234-241页

作者： Dennis Vaidakis John Karoubalis Theodora Pappa george piaditis george N Zografos Third Department of Surgery Athens General Hospital Department of Gastroenterology Athens General Hospital Department of Endocrinology Athens General Hospital

BACKGROUND:Although insulinomas are very rare tumors, they are the most common pancreatic neuroendocrine *** incidence in general population is 1-4 per 1 000 000 yearly but the incidence is higher in autopsy studies. The malignancy of insulinomas is difficult to be predicted on the basis of their histological features,and the current WHO classification has been *** review aimed to summarize classical knowledge with current trends in the diagnosis and treatment of insulinomas. DATA SOURCES:A Medline search using terms'insulinoma', 'treatment'and'neuroendocrine tumors'was conducted. Additional references were sourced from key articles. RESULTS:Surgery is the treatment of choice for insulinoma and has an extremely high success *** treatment is also available but only for patients who are unable or unwilling to undergo surgical *** localization is necessary for planning the surgical *** methods exist for localization of an insulinoma and can be invasive and *** combination of biphasic thin section helical CT and endoscopic ultrasonography(EUS)has an almost 100% sensitivity in localizing *** ultrasound is mandatory to localize intraoperatively these ***-guided fine needle tattoing is an alternative method of localization in case of lack of laparoscopic ultrasound. CONCLUSION:Laparoscopic resection for benign insulinomas is the procedure of choice,whereas pancreatectomy is reserved for large,potentially malignant tumors.

关键词： insulinoma pancreas neuroendocrine tumor diagnosis treatment

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