title: Intra-operative blood glucose and serum insulin concentrations in the surgical management of insulinoma.
abstract: The surgical management of insulinoma is frequently complicated by difficulty in pre- and intra-operative localization of the tumour. An early and reliable post-operative indicator of successful surgery would therefore be useful in the management of this condition. In a prospective, controlled study serial measurements of blood glucose and serum insulin concentrations were performed in 5 patients with insulinoma during surgical removal of the tumour. Results were compared with 5 patients, matched for age and body weight, undergoing abdominal surgery for non-malignant disease. Serum insulin (mean +/- s.e.m.) was significantly elevated in the insulinoma patients at the start of surgery (32.1 +/- 3.1 vs 6.1 +/- 2.2 mU/l; P less than 0.01). A significant fall (P less than 0.01) to levels comparable with the control patients (7.5 +/- 1.8 vs 10.0 +/- 3.3 mU/l) occurred following removal of the tumour. We conclude that serial intra-operative measurements of serum insulin concentration are technically simple to perform and provide useful retrospective corroboration of successful surgery in patients with insulinoma.
authors.affiliation: General Hospital, Birmingham, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Krentz
authors.forename: P J
authors.initials: PJ
authors.lastname: Hale
authors.forename: R M
authors.initials: RM
authors.lastname: Baddeley
authors.forename: A C
authors.initials: AC
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Natrass
mesh_terms: D007516:Adenoma, Islet Cell / Q000601:surgery*; D001786:Blood Glucose / Q000378:metabolism*; D002986:Clinical Trials as Topic; D006801:Humans; D007328:Insulin / Q000097:blood*; D007340:Insulinoma / Q000097:blood / Q000601:surgery*; D007430:Intraoperative Care; D010190:Pancreatic Neoplasms / Q000097:blood / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin