Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience.
BACKGROUND
The increasingly widespread use of minimally invasive surgery has allowed surgeons to exploit this approach for complex procedures, such as pancreatic resections, though its actual role outside simple operations remains debated.


METHODS
This is a study of 12 consecutive patients, 5 men and 7 women, with pancreatic insulinoma who were treated at our institution from 2000 to September 2005. All patients presented with typical symptoms and laboratory findings of hyperinsulinism and were good candidates for laparoscopic surgery. Preoperative diagnostic work-up, operating time, postoperative complication rate, length of hospital stayd and clinical outcome were assessed.


RESULTS
Successful laparoscopic resection was performed in 11 out of 12 patients: 4 had tumor enucleation, and 7 had distal pancreatectomy; among these latter 5 had spleen-preserving distal pancreatectomy. In 1 case conversion to open surgery was necessary. Mean operative time was 170 minutes. The median tumor size was 18 mm, and all the insulinomas were benign. Four complications were observed in this group, and the median hospital stay was 8 days.


CONCLUSIONS
The laparoscopic approach proved to be feasible and safe, although the average operative time was longer and demanded good surgical skills as well as precise localization of the tumor and definition of its nature. Tumors located in the body or tail of the pancreas that are benign in nature can better benefit of laparoscopic approach.
Toniato
Antonio
A
Surgical Pathology, Department of Clinical and Medical Science, University of Padua, Padua, Italy. giorgiolina@libero.it
Meduri
Francesco
F
Foletto
Mirto
M
Avogaro
Angelo
A
Pelizzo
MariaRosa
M
D000328:Adult; D000368:Aged; D000792:Angiography; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome