Laparoscopic Localization and Resection of Insulinomas

Dawn E. Jaroszewski, Richard T. Schlinkert, Geoffrey B. Thompson, Denise K. Schlinkert

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Hypothesis: Laparoscopic localization and resection of insulinomas are feasible and safe and may decrease morbidity and the length of hospitalization. Design: Case series identified through retrospective medical record review. Setting: Mayo Clinic, Scottsdale, Ariz, and Rochester, Minn, a single-institution tertiary care medical center. Patients: Nine patients (6 men and 3 women; mean age, 54 years) who underwent attempted laparoscopic insulinoma resection between September, 1997, and April, 2002. Interventions: Laparoscopic localization and resection of insulinoma tumors of the pancreas. Main Outcome Measures: Intraoperative complications, conversion to open laparotomy, and length of hospitalization. Results: Preoperative localization was successful in 5 patients (56%). Four conversions to open exploration were required because of an inability to identify the tumor (n = 3) or to perform a safe laparoscopic resection owing to proximity to the portal vein (n = 1). Laparoscopic intraoperative ultrasonography facilitated identification of lesions (mean tumor size, 2.1 cm) in 4 (80%) of 5 patients; 3 patients underwent successful laparoscopic resection. Average hospital stay was shorter after laparoscopic resection (4.5 vs 7.0 days in uncomplicated cases). At follow-up (mean, 29 months; range, 3-57 months), 1 patient who underwent laparoscopic enucleation had recurrent hypoglycemia. Conclusions: Laparoscopic localization and resection of insulinomas are feasible and safe. Laparoscopic ultrasound aids successful insulinoma localization and laparoscopic resection. Preoperative localization is not required, but previous knowledge of tumor location helps focus intraoperative ultrasound and limit pancreatic mobilization. Excluding patients with pancreatic leaks (observed in both groups), hospital stay and time to recovery may be shortened by using laparoscopic insulinoma resection.

Original languageEnglish (US)
Pages (from-to)270-274
Number of pages5
JournalArchives of Surgery
Volume139
Issue number3
DOIs
StatePublished - Mar 2004

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Insulinoma
Length of Stay
Neoplasms
Hospitalization
Intraoperative Complications
Portal Vein
Hypoglycemia
Tertiary Care Centers
Laparotomy
Medical Records
Pancreas
Ultrasonography
Outcome Assessment (Health Care)
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

Jaroszewski, D. E., Schlinkert, R. T., Thompson, G. B., & Schlinkert, D. K. (2004). Laparoscopic Localization and Resection of Insulinomas. Archives of Surgery, 139(3), 270-274. https://doi.org/10.1001/archsurg.139.3.270

Laparoscopic Localization and Resection of Insulinomas. / Jaroszewski, Dawn E.; Schlinkert, Richard T.; Thompson, Geoffrey B.; Schlinkert, Denise K.

In: Archives of Surgery, Vol. 139, No. 3, 03.2004, p. 270-274.

Research output: Contribution to journalArticle

Jaroszewski, DE, Schlinkert, RT, Thompson, GB & Schlinkert, DK 2004, 'Laparoscopic Localization and Resection of Insulinomas', Archives of Surgery, vol. 139, no. 3, pp. 270-274. https://doi.org/10.1001/archsurg.139.3.270
Jaroszewski DE, Schlinkert RT, Thompson GB, Schlinkert DK. Laparoscopic Localization and Resection of Insulinomas. Archives of Surgery. 2004 Mar;139(3):270-274. https://doi.org/10.1001/archsurg.139.3.270
Jaroszewski, Dawn E. ; Schlinkert, Richard T. ; Thompson, Geoffrey B. ; Schlinkert, Denise K. / Laparoscopic Localization and Resection of Insulinomas. In: Archives of Surgery. 2004 ; Vol. 139, No. 3. pp. 270-274.
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