Value of abdominal sonography and MR imaging at 0.5 T in preoperative detection of pancreatic insulinoma: a comparison with dynamic CT and angiography

Angeli, Enzo; Vanzulli, Angelo; Castrucci, M; Venturini, Massimo; Sironi, Sandro; Zerbi, Alessandro; Carlo, V. Di; Pozza, G.; Maschio, Alessandro Del

doi:10.1007/s002619900193

Cited by 46 publications

(18 citation statements)

References 27 publications

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“…10 The overall accuracy of non-invasive tests in our study was only 25% (PPV, 67%) and this compares with other studies. 9 The accuracy of selective angiography was 44% and THPVS was 40%. This was similar to the University of Table 6 Major complications in 9 patients…”

Section: Discussionmentioning

confidence: 99%

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Ravi

Britton

2007

annals

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Insulinoma is a rare and elusive, but the most common, curable endocrine tumour of the pancreas. The incidence is estimated at 4 cases per million-person years.1 The ability to localise the tumour accurately before or during surgery is an important factor in the management of these lesions. In the event of failed localisation, a blind pancreatic resection is no longer recommended. The development of sensitive radioimmunoassays to detect endogenous hyperinsulinaemia resulted in extensive investigations to localise the tumour preoperatively, in the belief that this would reduce morbidity from pancreatic exploration. These pre-operative tests included ultrasound scans (USS), computerised tomography (CT), magnetic resonance imaging (MRI), selective angiography, transhepatic portal venous sampling (THPVS), endoscopic ultrasound (EUS), octreotide scans and calcium stimulation arteriography. There is a wide variation in the sensitivity of these tests and there is no clear consensus in the choice of these tests even amongst enthusiasts.2,3 Some believe that meticulous intra-operative exploration combined with intra-operative ultrasound (IOUS) has a higher sensitivity than pre-operative localisation tests. 4,5 We have reviewed our experience of these lesions to assess if pre-operative localisation tests are necessary and to formulate a rational management strategy for these lesions. Insulinoma is a rare, but curable, endocrine tumour. The ability to localise the tumour accurately before or during surgery is an important factor in the management of these elusive lesions, which has been extensively debated. We have reviewed our experience of these lesions to establish the role of localisation tests. SURGICAL ONCOLOGY

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Section: Discussionmentioning

confidence: 99%

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Ravi

Britton

2007

annals

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“…The method's sensitivity in the diagnosis of pancreatic tumours is much lower -39% (17-79%) [38,[45][46][47][48][49][50].…”

Section: Ultrasonographymentioning

confidence: 99%

Zalecenia ogólne dotyczące postępowania w nowotworach neuroendokrynnych układu pokarmowego (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

Kos–Kudła¹,

Blicharz-Dorniak²,

Strzelczyk³

et al. 2014

Endokrynologia Polska

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An increased interest in gastro-entero-pancreatic neuroendocrine neoplasms (GEP NENs) has recently been observed. These are rare neoplasms and their detection in recent years has improved. Over 50% of GEP NENs are carcinoids, and they are usually found incidentally during surgery in the small intestine and appendix and at diagnosis in distant metastases, mainly to the liver. There is a need for co-operation between specialists in various disciplines of medicine in order to work out the diagnostic and therapeutic guidelines. In this publication, we present general recommendations of the Polish Network of Neuroendocrine Tumours for the management of patients with GEP NENs, developed at the Consensus Conference which took place in Kamień Śląski in April 2013. Members of the guidelines working groups were assigned sections of the 2008 guidance to update. In the subsequent parts of this publication, we present the rules of diagnostic and therapeutic management of: -neuroendocrine neoplasms of the stomach and duodenum (including gastrinoma); -pancreatic neuroendocrine neoplasms; -neuroendocrine neoplasms of the small intestine and the appendix; -colorectal neuroendocrine neoplasms. The proposed recommendations by Polish and foreign experts representing different fields of medicine (endocrinology, gastroenterology, surgery, oncology, nuclear medicine and pathology) will be helpful in the diagnosis and treatment of GEP NENs patients.

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“…The general characteristics of the patients and tumors are reported in table 1. All these patients were preoperatively investigated with color-Doppler sonography [10]and computed tomography; some patients underwent additional investigations, such as magnetic resonance tomography, and rarely angiography.…”

Section: Methodsmentioning

confidence: 99%

Surgical Treatment of Benign and Borderline Neoplasms of the Pancreatic Body

Balzano¹,

Zerbi²,

Veronesi³

et al. 2003

Dig Surg

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Background: Conventional operations for benign and borderline tumors of the pancreatic body are distal pancreatectomy and enucleation. An unusual operation allowing the preservation of the proximal and distal pancreas is median pancreatectomy. Method: A retrospective analysis of prospectively collected data on 67 patients with nonmalignant neoplasms of the pancreatic body was performed. The operations were: 32 median pancreatectomies (22 with duct occlusion of the distal pancreas, 10 with pancreaticojejunostomy), 21 distal pancreatectomies, and 14 enucleations. The operative and long-term outcomes of the different operations were compared. Results: Enucleation had a shorter operative time and less blood loss than the other operations. No mortality was observed. The pancreatic fistula rate was 50% after median pancreatectomy (59% in case of distal duct occlusion, 30% in case of pancreaticojejunostomy), 14% after distal pancreatectomy and 14% after enucleation. Diabetes appeared in 3 patients after distal pancreatectomy and 3 patients after median pancreatectomy with duct occlusion. Conclusions: When indicated, enucleation is the operation of choice for a nonmalignant neoplasm of the pancreatic body. With respect to distal resection, the higher fistula rate of median pancreatectomy with pancreaticojejunostomy could be the price for a better long-term endocrine function; median pancreatectomy with duct occlusion had worse operative results and no long-term advantages.

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Value of abdominal sonography and MR imaging at 0.5 T in preoperative detection of pancreatic insulinoma: a comparison with dynamic CT and angiography

Cited by 46 publications

References 27 publications

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Surgical Approach to Insulinomas: Are Pre-Operative Localisation Tests Necessary?

Zalecenia ogólne dotyczące postępowania w nowotworach neuroendokrynnych układu pokarmowego (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

Surgical Treatment of Benign and Borderline Neoplasms of the Pancreatic Body

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