Analysis of a series for surgical management of insulinomas in central China

Autor: Yongfu Zhao, Shishi Qiao, Yufei Gu, Hao Liu, Minghao Dong, Xin Hu, Guokun Zhang, Yingxuan Zhang, Liangjie Feng
Rok vydání: 2021
Předmět:
Popis: The aims of this study were to summarize the characteristics of insulinoma in central China and to present our experience with surgical management in the Department of Hepatobiliary and Pancreatic Surgery of The First Affiliated Hospital of Zhengzhou University. 617 patients were enrolled in this retrospective analysis, including 89 cases of insulinoma and 528 cases of other pancreatic tumors. All patients had been confirmed by histopathology reports and underwent surgical treatment. Medical data and operative notes were incorporated into the database. Among the 617 patients, 4 died during the perioperative period. In the insulinoma group, no deaths occurred. The average size of the insulinoma tumor was 1.4±0.8 cm. The ratio of open surgical procedure (57) to laparoscopic resection (32) was 1.8/1. The mean interoperation blood loss was significantly lower in the laparoscopic group (LA) (mean 35.2±17.4ml, range from 10 to 170ml) than that in the open surgical (OA) group (mean 64.7±38.6ml, range from 25 to 400ml). The mean postoperative hospital stay was also lower in the LA group (mean 8.1 ± 3.2days, range from 5 to 20 days) than that in the OA group (Mean 13.1±8.2days, range from 9 to 60 days). There was no significant difference for postoperative complications between the two groups (LA:37.5% vs OA:40.3% ). The rate of clinically significant postoperative-pancreatic-fistula (POPF) was 21.3 %, and there was only one case of C-degree-POPF. The average length of postoperative- gastrointestinal function recovery was 2.8 ± 0.9 days. And the average length of blood glucose fluctuation was 18±7.2 days. During the follow-up, 2 cases were found to be hypoglycemic again, and the rate of significant weight loss was 57.3% (51/89). Insulinoma was rare among patients who underwent surgical treatment at the Department. Their cases were benign, and their treatment was unproblematic. However, there was a small group of cases that could be associated with problematic clinical situations, and, therefore, treatment of patients with insulinoma should be conducted at specialist centers. Correct diagnostic and therapeutic management, involving close cooperation between multiple medical specialists, results in completely curing most patients.
Databáze: OpenAIRE