Is Preoperative Radiographic Localization of Islet Cell Tumors in Patients with Insulinoma Necessary?
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Preoperative localization tests [sonography, computed tomography, angiography, percutaneous transhepatic portal venous sampling for insulin radioimmunoassay (PTP)] have a sensitivity of 60% to 90% in cases of organic hyperinsulinism. In all publications, however, the sensitivity of intraoperative localization, 75% to 100%, is distinctly higher. With the exception of PTP, all tumors that can be identified by preoperative localization can also be detected using palpation or intraoperative sonography. Preoperative localization diagnosis is therefore not absolutely necessary prior to primary operation in the case of organic hyperinsulinism. It is requested by many surgeons because: (1) only a few clinics have extensive experience with patients with an organic hyperinsulinism; (2) only a few clinics have extensive experience with intraoperative sonography; (3) the accuracy of palpation is improved following appropriate preoperative localization; and (4) in rare cases, the results of a PTP influence the operative procedure.
Jodal A, Lankat-Buttgereit B, Brom M, Schibli R, Behe M EJNMMI Res. 2014; 4:31.
PMID: 25006548 PMC: 4078388. DOI: 10.1186/s13550-014-0031-9.
Neuroendocrine tumors of the pancreas.
Davies K, Conlon K Curr Gastroenterol Rep. 2009; 11(2):119-27.
PMID: 19281699 DOI: 10.1007/s11894-009-0019-1.
Laparoscopic surgery for pancreatic insulinomas: a single-institution experience of 29 cases.
Luo Y, Liu R, Hu M, Mu Y, An L, Huang Z J Gastrointest Surg. 2009; 13(5):945-50.
PMID: 19224293 DOI: 10.1007/s11605-009-0830-x.
[Invasive diagnostic procedures for insulinomas of the pancreas].
Noldge G, Weber M, Ritzel R, Werner M, Kauczor H, Grenacher L Radiologe. 2009; 49(3):224-32.
PMID: 19198794 DOI: 10.1007/s00117-008-1786-7.
Surgical approach to insulinomas: are pre-operative localisation tests necessary?.
Ravi K, Britton B Ann R Coll Surg Engl. 2007; 89(3):212-7.
PMID: 17394700 PMC: 1964736. DOI: 10.1308/003588407X179008.