title: Role of preoperative endoscopic ultrasound-guided fine-needle tattooing of a pancreatic head insulinoma.
abstract: Although insulinomas are rare, they are the most common pancreatic neuroendocrine tumor, with an incidence of four cases per million population. Insulinomas are generally benign indolent intrapancreatic tumors. Surgical resection remains the main option for treatment. However, up to 67% of a pancreatic head insulinomas are nonpalpable, thus surgical resection of the nonplapable insulinoma in this area could become problematic resulting in prolonged surgical time, increased risk of pancreatic duct injury and need for pancreaticoduodenectomy. Endoscopic ultrasound-guided fine- needle tattooing (EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating laparoscopic distal pancreatectomy and helping surgeons identify the location of the tumor. EUS-FNT might have a role for preoperative localization of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surgical resection, reduce operative time and decrease surgical complications.
authors.affiliation: Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
authors.forename: Pornchai
authors.initials: P
authors.lastname: Leelasinjaroen
authors.affiliation: Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
authors.forename: Wuttiporn
authors.initials: W
authors.lastname: Manatsathit
authors.affiliation: Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Berri
authors.affiliation: Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Barawi
authors.affiliation: Pornchai Leelasinjaroen, Wuttiporn Manatsathit, Department of Medicine, St. John Hospital and Medical Center, Detroit, MI 48236, United States.
authors.forename: Frank G
authors.initials: FG
authors.lastname: Gress
keywords: Endoscopic ultrasound-guided fine-needle tattooing; Endosonography; Insulinoma; Neuroendocrine tumors; Pancreas