Localization of insulinomas.
OBJECTIVE
Intraoperative ultrasonography is more sensitive than preoperative and other intraoperative techniques for localizing insulinoma.


METHODS
Retrospective review.


METHODS
A tertiary referral center.


METHODS
All patients with a biochemical diagnosis of organic hyperinsulinism who were referred to University of California, San Francisco, from 1975 to 1998.


METHODS
Sensitivities of the localization techniques for insulinoma were evaluated.


RESULTS
The sensitivities of tumor localization with arteriography, computed tomography, preoperative ultrasonography, magnetic resonance imaging, magnetic resonance imaging with gadolinium, transhepatic venous sampling, palpation, and intraoperative ultrasonography were 47%, 24%, 50%, 30%, 40%, 55%, 76%, and 91%, respectively. Nine of the 11 nonpalpable and nonvisible tumors at operation were localized by intraoperative ultrasonography.


CONCLUSIONS
The currently available preoperative localization tests are not reliable enough to be recommended when intraoperative ultrasonography is available.
Boukhman
M P
MP
Department of Surgery, University of California, San Francisco 94115, USA.
Karam
J M
JM
Shaver
J
J
Siperstein
A E
AE
DeLorimier
A A
AA
Clark
O H
OH
D000328:Adult; D003952:Diagnostic Imaging / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D007430:Intraoperative Care; D008297:Male; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography