title: [Pancreatic insulinomas].
abstract: Insulinoma is the most frequent neuroendocrine pancreatic tumor. In the present study, the clinical and immunohistochemical results of 20 patients who underwent surgery between January 1986 and December 2004 were evaluated. Clinical presentation, laboratory data, imaging studies, aspects of the surgical technique, complication rates and medium- and long-term follow-up were analyzed. Surgical treatment was recommended in all patients based on presenting symptoms and laboratory signs of hypoglycemia and hyperinsulinemia. In 15 patients, the lesion was identified preoperatively. In the 5 remaining patients, intraoperative palpation and ultrasonography were used to locate the lesion. The most frequently performed surgical procedures were pancreatic resection in 10 patients and laparotomic enucleation in the remaining 10. Laparoscopy was used in two patients. Two patients developed diabetes mellitus. The most frequent surgical complication was pancreatic fistula. No mortality was observed in the present series. Symptom reversion, characterized by disappearance of Whipple's triad and normal or increased glycemia values compared with preoperative values, was observed in all patients.
authors.affiliation: Disciplina de Gastroenterología Quirúrgica, Escuela Paulista de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil. apodaca@uol.com.br
authors.forename: Franz R
authors.initials: FR
authors.lastname: Apodaca-Torrez
authors.forename: Tarcisio
authors.initials: T
authors.lastname: Triviño
authors.forename: Edson José
authors.initials: EJ
authors.lastname: Lobo
authors.forename: Alberto
authors.initials: A
authors.lastname: Goldenberg
authors.forename: M Ricardo
authors.initials: MR
authors.lastname: Benvenuto
authors.forename: José Celso
authors.initials: JC
authors.lastname: Ardeng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery