[Peroperative echography in 14 cases of pancreatic insulinoma and gastrinoma].
Fourteen cases of endocrine tumors (10 insulinomas and 4 gastrinomas) were to studied by intraoperative ultrasonography (IOU). Localization was established by preoperative ultrasonography in 1/14, by CT scan in 1/11, by arteriography in 6/12 and by pancreatic venous sampling in 7/8. Tumor size ranged from 0.5 cm to 2.5 cm. Manual palpation was positive in 10/14. The tumor was accurately and completely localized by IOU in 9/10 insulinomas: the one false negative was probably due to micro-adenoma. The intrapancreatic tumor was localized only in 1/14 gastrinomas. Intraoperative sonography localized lymph nodes in all cases. One distal pancreatectomy was improperly performed because of an accessory spleen. After reviewing 59 other cases in the literature, we propose: a) to abandon venous sampling in insulinomas because of adequate performance of IOU; b) to use IOU as a complementary investigative method along with other preoperative methods of localization in gastrinoma.
Marotel
M
M
Service de Radiologie Centrale, Hôpital Broussais, Paris.
Hernigou
A
A
Plainfossé
M C
MC
Alexandre
J H
JH
Chapuis
Y
Y
Dazza
F E
FE
D007516:Adenoma, Islet Cell / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D015408:Gastrinoma / Q000175:diagnosis*; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D014463:Ultrasonography
Echographie per-opératoire au cours de 14 cas d'insulinomes et de gastrinomes pancréatiques.