title: [Laparoscopic surgical treatment of insulinomas with the use of intraoperative ultrasonography].
abstract: BACKGROUND
  Insulinoma are insulin productive tumors originated from the pancreatic beta cells with an incidence of 4/1 million persons. It is more prevalent between the 5th and 6th decade, in women (2:1) and from the endocrine pancreatic tumor is the more frequent (50% to 60%). Insulinoma behave as a benign tumor when the diameter is inferior to 2 cm. The diagnosis is mainly clinical and laboratorial. Surgery is the unique treatment with potential cure.
  
  
  OBJECTIVE
  The present observation reports the use of simultaneous laparoscopic resection associated to intraoperative ultrasonography.
  
  
  METHODS
  Five patients were studied (3 man and 2 women) with age from 20 to 53 years old, clinically diagnosed with insulinoma. After image work out it was proposed nuclear resection of the insulinoma by laparoscopic technique associated to intraoperative ultrasonography.
  
  
  RESULTS
  The patients had a complete remission of tumor related hypoglycemia and one patient developed a pancreatic fistula and other a pancreatic pseudocist with good postoperative resolution.
  
  
  CONCLUSIONS
  The videolaparoscopic approach for the surgical treatment of insulinoma is feasible. The intraoperative ultrasonography helps to identify the lesions and check their complete resection with low complication rate.
authors.affiliation: Serviço de Cirurgia Pro-Gastro - Coloproctologia, Gastroenterologia Clínica e Cirúrgica, Hospital São Joaquim, São Paulo, SP. tarikolivar@globo.com
authors.forename: Tárik Olívar de Nunes
authors.initials: TO
authors.lastname: Valente
authors.forename: Pedro Luiz
authors.initials: PL
authors.lastname: Bertevello
authors.forename: Dan L
authors.initials: DL
authors.lastname: Waitzberg
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gama-Rodrigues
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014741:Video Recording