Laparoscopic enucleation of insulinomas.
OBJECTIVE
Laparoscopic enucleation of insulinomas is safe and effective and is associated with a short hospital stay.


METHODS
Case series identified through retrospective review of medical records.


METHODS
University of California, San Francisco Medical Center, a tertiary care referral hospital.


METHODS
Nine patients with insulinomas that were thought to be suitable for laparoscopic enucleation.


METHODS
Laparoscopic enucleation of solitary insulinomas of the pancreas.


METHODS
Successful enucleation, conversion to open operation, postoperative complications, and duration of hospitalization.


RESULTS
Seven of 9 patients had curative laparoscopic enucleations of insulinomas. In the 2 other patients, the laparoscopic approach was converted to an open operation to perform a distal pancreatectomy. All patients were cured. Computed tomography (CT) localized the tumor in 5 of 9 patients; laparoscopic enucleation was successful in all 5. Endoscopic ultrasonography correctly identified the lesions in 2 of 3 patients with nondiagnostic CT scans. Both lesions were successfully enucleated laparoscopically. Postoperative pancreatic fistulas occurred in 7 of 9 patients, but they caused little morbidity. No patient required another operation. Five of 7 patients treated laparoscopically were discharged to home on the first postoperative day.


CONCLUSIONS
Laparoscopic enucleation was safe and effective. If the lesion was seen on CT, it could be removed laparoscopically. Endoscopic ultrasonography was useful for identifying lesions in patients whose CT scans were nondiagnostic. Pancreatic fistulas were common, but they resolved spontaneously and produced little morbidity. Laparoscopic enucleation resulted in a short hospitalization and rapid recovery for most patients.
Sweet
Matthew P
MP
Surgical Service, Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121, USA.
Izumisato
Yumi
Y
Way
Lawrence W
LW
Clark
Orlo H
OH
Masharani
Umesh
U
Duh
Quan-Yang
QY
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*