Laparoscopic Enucleation of Insulinomas

Sweet, Matthew P.; Izumisato, Yumi; Way, Lawrence W.; Clark, Orlo H.; Masharani, Umesh; Duh, Quan Yang

doi:10.1001/archsurg.142.12.1202

Cited by 46 publications

(46 citation statements)

References 8 publications

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“…However, many high-degree malignant cases, such as pancreatic ductal adenocarcinoma, were also reported in Lap PD. Lap EN is mostly applied to insulinoma and some rare cases, such as nonfunctioning neuroendocrine tumors [16][17][18]. Mabrut [19] reviewed 127 laparoscopic pancreatic operations in 25 European medical centers and found that 87% of the cases were benign tumors.…”

Section: Indicationmentioning

confidence: 99%

“…The average hospital stay was 18 days (range: 7-39 days), and the average conversion rate was 46% (range: 12%-100%). The mean number of lymph nodes in the pathology was 19 (range: [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The complication rates were 16% and mortality was recorded in only 2 (1.3%) patients during the perioperative period.…”

Section: Lap Pdmentioning

confidence: 99%

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Laparoscopic surgery for pancreatic lesions: current status and future

Zhang

Zhao

2011

Front. Med.

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Laparoscopic pancreatic surgery has been gaining increasing recognition in recent years, and its practice has increased despite its highly complex procedure and longer learning curve compared with surgeries for other abdominal organs. Laparoscopic distal pancreatectomy and tumor enucleation are two of the fastest-growing techniques and are currently in wide use because of their comparable technical simplicity. Literature review showed that laparoscopic distal pancreatectomy and enucleation are safe and efficient approaches for benign and low-degree malignant tumors; however, the indication for malignant tumors remains controversial. Laparoscopic pancreaticoduodenectomy is practiced in a limited number of surgical centers and presented as case reports or in small series. Although its feasibility was demonstrated by many surgeons, whether the laparoscopic procedure can achieve benefits comparable to or even more prominent than those of an open procedure has not been clinically proven. Prospective, randomized, controlled trials of laparoscopic operation versus open pancreatic surgery are necessary to justify the wide application and routine practice of the laparoscopic procedure for pancreatic lesions.

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Section: Indicationmentioning

confidence: 99%

Section: Lap Pdmentioning

confidence: 99%

Laparoscopic surgery for pancreatic lesions: current status and future

Zhang

Zhao

2011

Front. Med.

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“…Furthermore, reports show intraoperative ultrasound (IOUS) to be useful for detecting and localizing insulinomas, with an accuracy of 83-100% (Level II-III) [20][21][22][23][24][25] Sensitivity has been reported to be better than that of preoperative angiography. Recent publications also confirm the ability of LUS to detect neuroendocrine tumors of the pancreas as small as 3-5 mm in diameter [23,26,27]. The ability of intraoperative ultrasound to detect extrahepatic gastrinoma is lower (about 58%) (Level III) [28,29].…”

Section: Risks and Benefitsmentioning

confidence: 86%

SAGES guidelines for the use of laparoscopic ultrasound

et al. 2009

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PreambleThe use of ultrasound in the operating room by surgeons is increasing, and the indications and use of ultrasound by laparoscopists and endoscopists are evolving. These guidelines are intended to provide current recommendations for the use and benefits of laparoscopic ultrasound (LUS) for the surgeon. They are not intended to show the only uses and applications but rather ones for which data are available to make a recommendation. Recommendations are based on the current medical evidence and are graded according to that evidence. DisclaimerClinical practice guidelines are intended to indicate the best available approach to medical conditions as established by systematic review of available data and expert opinion. The approach suggested may not be the only acceptable one given the complexity of the health care environment. These guidelines are intended to be flexible, as the surgeon must always choose the approach best suited to the patient and to the variables in existence at the time of the decision. These guidelines are applicable to all physicians who are appropriately credentialed and address clinical situations regardless of specialty.Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and its guidelines committee and approved by the Board of Governors. The recommendations for each guideline undergo multidisciplinary review and are considered valid at the time of production based on the data available. Recent developments in medical research and practice pertinent to each guideline will be reviewed, and guidelines will be updated on a periodic basis. Literature review methodsA moderate body of literature applies to LUS. Our systematic literature search of MEDLINE for the period 1966 through May 15, 2007, limited to English-language articles, identified 146 relevant reports. The search strategy used the terms The articles were divided into the following categories:(a) Randomized studies, meta-analyses, and systematic reviews (b) Prospective studies (c) Retrospective studies (d) Case reports (e) Review articles All case reports, old reviews, and smaller studies were excluded.

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“…Pancreatic resection using the laparoscopic approach has been reported recently [17,18,19,20]. A patient with solid and cyst-papillary neoplasm who underwent laparoscopic partial resection was experienced in our institute.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Pancreatic Duct Stenting prior to Surgery as a Guide to Decide the Feasibility of Limited Pancreatic Resection

Okamoto¹,

Gocho²,

Futagawa³

et al. 2008

Dig Surg

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Background/Aims: The purpose of this study was to introduce our procedure of limited pancreatic resection with preoperative pancreatic duct stenting to prevent complications. Patients and Methods: Subjects comprised 6 patients with neoplasm who underwent preoperative pancreatic stenting. Pancreatic stents were placed within 7 days before elective surgery. After intraoperative ultrasonography, the relationship between the main pancreatic duct (MPD) and the lesion was confirmed by measuring the distance. Partial resection was surrendered if a sufficient margin of excised tumor was not obtained or injury to the MPD was likely to occur. Branches of pancreatic duct recognized were ligated as much as possible. Results: Mild pancreatitis was present after stenting in 2 patients. Three patients actually underwent partial resection. In patients with partial resection, enhanced visualization of the MPD was useful for deciding the operative procedure and prevented iatrogenic injury to the MPD during dissection. Conclusions: Pancreatic duct stenting prior to pancreatic surgery seems useful as a guide for determining the feasibility of limited pancreatic resection and to prevent missing injury to the MPD.

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Laparoscopic Enucleation of Insulinomas

Abstract: Laparoscopic enucleation of insulinomas is safe and effective and is associated with a short hospital stay.Design: Case series identified through retrospective review of medical records.

Cited by 46 publications

References 8 publications

Laparoscopic surgery for pancreatic lesions: current status and future

Laparoscopic surgery for pancreatic lesions: current status and future

SAGES guidelines for the use of laparoscopic ultrasound

Usefulness of Pancreatic Duct Stenting prior to Surgery as a Guide to Decide the Feasibility of Limited Pancreatic Resection

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