Laparoscopic surgery for pancreatic insulinomas: a single-institution experience of 29 cases.
BACKGROUND
Laparoscopic approach has been increasingly used in the treatment of pancreatic benign diseases. This report evaluates our experience with laparoscopic surgery for pancreatic insulinomas.


METHODS
Between July 2000 and December 2007, laparoscopic pancreatectomy was attempted in 29 consecutive patients with insulinomas. The localization of tumors, operating characteristics, and clinical outcomes were analyzed.


RESULTS
Tumors were precisely localized in 28 of 29 (96.6%) patients by a combination of preoperative imaging techniques and intraoperative ultrasonography. Laparoscopic pancreatectomy was successfully performed in 26 patients, including enucleation (n = 14), hand-assisted enucleation (n = 2), and distal pancreatectomy with (n = 9) or without (n = 1) spleen preservation. Two conversions to open procedure were required because of unfavorable locations of the tumors. The pancreatic fistula occurred in four patients who underwent tumor enucleation. The median hospital stay was 5.5 days (range, 3-18 days) after laparoscopic procedure. Twenty-eight patients with pancreatic resection were free of symptoms and remained normoglycemic after a median follow-up period of 19 months (range, 10-36 months).


CONCLUSIONS
Laparoscopic pancreatic resection is a feasible and safe procedure for patients with insulinomas. Further studies are required to evaluate the potential application of the hand-assisted approach for tumors located at anatomically unfavorable positions.
Luo
Ying
Y
Department of Hepatobiliary Surgery, The General Hospital of Chinese People Liberation Army, 28 Fu Xing Road, Beijing, China.
Liu
Rong
R
Hu
Ming-Gen
MG
Mu
Yi-Ming
YM
An
Li-Chun
LC
Huang
Zhi-Qiang
ZQ
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome