Surgical management of insulinomas: Short- and long-term outcomes after enucleations and pancreatic resections

Stefano Crippa, Alessandro Zerbi, Letizia Boninsegna, Vanessa Capitanio, Stefano Partelli, Gianpaolo Balzano, Paolo Pederzoli, Valerio Di Carlo, Massimo Falconi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To analyze the characteristics and outcomes following enucleation and pancreatic resections of insulinomas. Design: Retrospective cohort study; prospective database. Settings: Academic, tertiary, and referral centers. Patients: Consecutive patients with insulinomas (symptoms of hyperinsulinism and positive fasting glucose test) who underwent surgical treatment between January 1990 and December 2009. Main Outcome Measures: Operative morbidity, tumor recurrence, and survival after treatment. Results: A total of 198 patients (58.5% women; median age, 48 years) were identified. There were 175 (88%) neuroendocrine tumors grade G1 and 23 (12%) neuroendocrine tumors grade G2. Malignant insulinomas defined by lymph node/liver metastases were found in 7 patients (3.5%). Multiple insulinomas were found in 8% of patients, and 5.5% of patients had multiple endocrine neoplasia type 1. Surgical procedures included 106 enucleations (54%) and 92 pancreatic resections (46%). Mortality was nil. Rate of clinically significant pancreatic fistula was 18%. Enucleations had a higher reoperation rate compared with pancreatic resections (8.5% vs 1%; P=.02). Multiple endocrine neoplasia type 1 was significantly associated with younger age at onset (P

Original languageEnglish
Pages (from-to)261-266
Number of pages6
JournalArchives of Surgery
Volume147
Issue number3
DOIs
Publication statusPublished - Mar 2012

ASJC Scopus subject areas

  • Surgery

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