title: Surgical treatment of pancreatic insulinomas.
abstract: BACKGROUND
  Insulinoma is a pancreatic neuroendocrine tumor originated from pancreatic islet beta cells. Although rare, is the most common pancreatic endocrine tumor, with about four cases per million people. The preferential treatment of insulinoma is surgical.
  
  
  OBJECTIVE
  To analyze the epidemiological, pathological, clinical and surgical patients treated in the last decade in two surgical services.
  
  
  METHODS
  Were retrospectively reviewed the medical records of patients undergoing surgical treatment of insulinoma in the period of 1999 to 2011. Demographic data, type and duration of symptoms, associated or not with endocrine syndrome and diagnostic tests were obtained from medical records. Were analyzed the method of surgery, intraoperative findings and immediate and late complications.
  
  
  RESULTS
  Sixteen patients with insulinoma underwent surgical treatment, 68,7% were women. The age ranged from 20 to 60 years, with a mean age of 39 years. Only one case was associated with multiple endocrine neoplasia type 1. Neuropsychiatric manifestations, mainly syncope, were the most prevalent. The average duration of clinical manifestations until the diagnosis was one year and a half. Imaging tests were used in all patients with 68.7% of preoperative tumor localization. All operations were performed in a conventional (open) manner, without use of laparoscopy. The lesions were identified in all portions of the pancreas with the majority in the pancreatic head. Relief of symptoms was not obtained only in one patient. There were no deaths among the patients.
  
  
  CONCLUSIONS
  The diagnosis of insulinoma is often established after several months of the onset of clinical manifestations and surgical treatment is curative in almost all patients.
authors: Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil. flatb_@hotmail.com
authors: Flávia Thaiana
authors: FT
authors: Bonato
authors: Júlio Cezar Uili
authors: JC
authors: Coelho
authors: Andrea
authors: A
authors: Petruzzielo
authors: Jorge Eduardo Fouto
authors: JE
authors: Matias
authors: Gustavo Arantes
authors: GA
authors: Ferreira
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult