Arterial Stimulation and Venous Sampling (ASVS) is Useful for Recurrent Lesions of Insulinoma
| Autor: | Tadatoshi Takayama, Yoshika Watanabe, Yoshikura Haraguchi, Shintaro Yamazaki, Toshisada Ueda, Naoko Kutsuna, Kazuhiko Wakabayashi, Atsuko Iwama, Yutaka Itoh |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Surgical margin Ultrasonic Therapy medicine.medical_treatment Enucleation Hypoglycemia Pancreatectomy Gastrointestinal Agents Recurrence medicine Humans Insulin Laparoscopy Insulinoma medicine.diagnostic_test business.industry Soft tissue Middle Aged medicine.disease Calcium Gluconate Surgery Pancreatic Neoplasms medicine.anatomical_structure Radiology Pancreas business |
| Zdroj: | Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 19:e138-e139 |
| ISSN: | 1530-4515 |
| DOI: | 10.1097/sle.0b013e3181ac7f97 |
| Popis: | We encountered a recurrent case of benign solitary insulinoma in the pancreatic tail, which may have been caused by an inadequate surgical margin in the use of an ultrasonic dissector. A 45-year-old man was referred with hypoglycemia and diagnosed solitary insulinoma in the pancreas. Laparoscopic pancreatic enucleation was performed using an ultrasonic dissector. The tumor was extracted and the surgical margins were microscopically negative. Six years later, he presented with hypoglycemia again. Multiple small well-enhanced lesions were detected by computed tomography distant from the resection stump of the first operation. He underwent resection of all visible lesions with omentum and wide excision of the soft tissue surrounding the pancreas after preoperative arterial stimulation and venous sampling test. The postoperative course of the second operation was uncomplicated and the patient presents no sign of hypoglycemia after 12 months. |
| Databáze: | OpenAIRE |
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