Laparoscopic ultrasonography for resection of insulinomas

Iihara, Masatoshi; Kanbe, Masako; Okamoto, Takahiro; Ito, Yukio; Obara, Takao

doi:10.1067/msy.2001.118382

Cited by 77 publications

(65 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In particular, in laparoscopic surgery, in which there is no tactile sensation for the surgeon, IOUS has gained results similar to open surgery. The lack of tactile sensation has been cited as an important factor in the failure to identify lesions and the resulting conversion to open surgery (Iihara et al 2001, Aggeli et al 2016. Laparoscopic pancreatic surgery started 20 years ago and has evolved to be safe in high-volume centers with results comparable with those of open PD (Correa-Gallego et al 2014).…”

Section: :10mentioning

confidence: 99%

The future: surgical advances in MEN1 therapeutic approaches and management strategies

Sadowski¹,

Cadiot²,

Dansin³

et al. 2017

Endocrine-Related Cancer

View full text Add to dashboard Cite

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary autosomal dominant disorder associated with numerous neuroendocrine tumors (NETs). Recent advances in the management of MEN1 have led to a decrease in mortality due to excess hormones; however, they have also led to an increase in mortality from malignancy, particularly NETs. The main challenges are to localize these tumors, to select those that need therapy because of the risk of aggressive behavior and to select the appropriate therapy associated with minimal morbidity. This must be applied to a hereditary disease with a high risk of recurrence. The overall aim of management in MEN1 is to ensure that the patient remains disease-and symptom-free for as long as possible and maintains a good quality of life. Herein, we review the changes that occurred in the last 20 years in the surgical management of MEN1-associated functional and non-functional pancreaticoduodenal NETs and thymic and bronchial NETs.

show abstract

Section: :10mentioning

confidence: 99%

The future: surgical advances in MEN1 therapeutic approaches and management strategies

Sadowski¹,

Cadiot²,

Dansin³

et al. 2017

Endocrine-Related Cancer

View full text Add to dashboard Cite

show abstract

“…Open enucleation is the procedure of choice for tumors located in head or uncinate process of the pancreas, because the laparoscopic approach is technically difficult [21, 35]. Resection may be required, when the tumor is located deep in the pancreatic head parenchyma and/or abuts pancreatic duct or major vessels.…”

Section: Discussionmentioning

confidence: 99%

Strategy for the Surgical Management of Insulinomas: Analysis of 52 Cases

Liu¹,

Peng

Zhang

et al. 2007

Dig Surg

View full text Add to dashboard Cite

Aim: The goal of this retrospective study was to analyze the strategy for the surgical management of insulinomas. Methods: From May 2000 to October 2006, the medical records of 52 patients with insulinomas were retrospectively studied. Results: All tumors were localized precisely by imaging techniques combined with intraoperative palpation. Forty-eight patients with benign lesions underwent surgical treatment: 41 patients open and 7 patients laparoscopic procedures. Four patients with malignant insulinomas underwent tumor resection; 3 of them underwent metastatic lesion and/or lymph node dissection. There were no discrepancies regarding operation time, blood loss, and complication rate between open enucleation and laparoscopic surgery. The mean hospital stay was 11.8 ± 3.4 days after laparoscopic surgery, shorter than the 17.0 ± 6.0 days after the open approach. Twenty-two complications occurred in 17 patients (32%) following resection. On follow-up, 86% of the patients were free from symptoms, and surgical cure was achieved in 95% of the patients with benign insulinomas. Conclusions: The choice of the surgical strategy for the treatment of pancreatic insulinomas depends on size and location of the tumor and the risk of malignancy. The optimal surgical procedure is key to prevent postoperative complications. The laparoscopic approach is safe and feasible for patients with benign tumors located in body or tail of the pancreas.

show abstract

“…Desde la introducción de la laparoscopia en el tratamiento del insulinoma en 1996 por Gagner (15) y Sussman (16), son cada vez más frecuentes los artículos publicados en la literatura de este tipo de abordaje, demostrando que esta técnica es sobre todo eficaz en los tumores pequeños, solitarios y de localización distal (17)(18)(19)(20)(21)(22)(23). La mayor dificultad radica en el diagnóstico de localización intraoperatoria, que constituye la causa más frecuente de conversión (hasta un 30% en grandes series), sin embargo la utilización de la ecografía laparoscópica está contribuyendo a disminuir estos problemas.…”

Section: Discussionunclassified

Manejo diagnóstico y terapéutico del insulinoma pancreático

Priego

Sanjuánbenito

Molina

et al. 2007

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

RESUMENIntroducción: el insulinoma es el tumor endocrino pancreáti-co más frecuente. Su diagnóstico preoperatorio ha sido motivo de controversia durante muchos años. El objetivo del trabajo es evaluar la experiencia del Hospital Ramón y Cajal en el manejo diagnóstico y terapéutico de este tipo de tumores.Material y métodos: en el periodo comprendido entre enero de 1999 y julio de 2006 fueron intervenidos en nuestro hospital 12 pacientes (9 mujeres y 3 varones) con el diagnóstico de insulinoma, con una edad media de 56 años (16-72 años).Resultados: la gammagrafía con octreótido nos permitió realizar el diagnóstico en el 33,3% de los casos, el TAC abdominal en el 83,3% y la ecoendoscopia en el 100%.El 100% de los insulinomas fue diagnosticado durante la cirugía gracias al uso de la ecografía intraoperatoria. En todos los casos se realizó la excisión completa del tumor, mediante 9 enucleaciones y 3 pancreatectomías distales.Dos pacientes presentaron una fístula pancreática y otro un pseudoquiste pancreático que se resolvieron de forma conservadora. La tasa de curación fue del 100%. El seguimiento fue de 48 meses, no encontrándose ningún caso de recidiva.Conclusión: en nuestra experiencia, creemos aconsejable la realización de TAC abdominal y ecoendoscopia como pruebas previas a la cirugía.Sin embargo, la técnica de elección sería la palpación del pán-creas y la realización de una ecografía intraoperatoria.La cirugía es curativa en el 100% de los casos, y la técnica efectuada dependerá del tamaño, localización y distancia del tumor al conducto pancreático, así como su relación con el síndro-me MEN-1.Palabras clave: Insulinoma. Tumor endocrino pancreático. Ecografía intraoperatoria. Ecoendoscopia. ABSTRACTIntroduction: insulinoma is the most frequent pancreatic endocrine tumor. Its preoperative diagnosis has been controversial for many years. The aim of this study was to evaluate the experience in the management and treatment of this kind of tumor at Hospital Ramón y Cajal.Material and methods: between January 1999 and July 2006, 12 patients were operated on in our hospital (9 females and 3 males) who had been diagnosed with insulinoma, with a mean age of 56 years (16-72 years).Results: octreotide scintigraphy allowed a diagnosis in 33.3% of cases, abdominal CT in 83.3%, and echoendoscopy in 100%. Intraoperative ultrasonography confirmed the presence of an insulinoma in 100% of cases. In all cases a complete excision was possible, with 9 enucleations and 3 distal pancreatectomies.Two patients developed a pancreatic fistula, and one a pancreatic pseudocyst that healed spontaneously without surgery. The overall cure rate was 100%. After a mean follow-up of 48 months no recurrences have been reported.Conclusion: in our experience, we consider advisable that abdominal CT and echoendoscopy be performed before surgery. However, the initial procedure of choice would be pancreas palpation and intraoperative ultrasonography. Surgery cured 100% of cases, and the procedure selected depends on size, location, distance from the m...

show abstract

Laparoscopic ultrasonography for resection of insulinomas

Cited by 77 publications

References 15 publications

The future: surgical advances in MEN1 therapeutic approaches and management strategies

The future: surgical advances in MEN1 therapeutic approaches and management strategies

Strategy for the Surgical Management of Insulinomas: Analysis of 52 Cases

Manejo diagnóstico y terapéutico del insulinoma pancreático

Contact Info

Product

Resources

About