Pancreatic Insulinoma Diagnosed after 25 years and Conservative Management of Pancreatic Fistula after Insulinoma Surgery

Ahmed Hassaan Malik; Shafaqat Ali

doi:10.51253/pafmj.v75i4.9149

Authors

Ahmed Hassaan Malik Department of General Surgery, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
Shafaqat Ali Department of General Surgery, Pakistan Navy Station Shifa Hospital, Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i4.9149

Keywords:

Insulinoma, Pancreatic Endocrine Tumor, Pancreatic Fistula.

Abstract

Insulinomas are the rare insulin secreting tumours of pancreatic origin. Their diagnosis is often challenging and delayed due to non-specific and variable symptoms of hypoglycemia. Once diagnosis is made, an appropriate surgical approach is required to prevent post-operative complications. The major challenge for surgeons remains the increased rate of post-operative complications after insulinoma surgery. We present a unique case of insulinoma diagnosed after 25 years and management of post-operative complications of fistula formation after its surgery.

Downloads

Download data is not yet available.

References

1. Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y, et al. Diagnosis and management of insulinoma. World J Gastroenterol 2013; 19(6): 829.

https://doi.org/10.3748/wjg.v19.i6.829

2. Zhuo F, Anastasopoulou C. Insulinoma. InStatPearls [Internet] 2022. StatPearls Publishing. [cited 2022 Dec 24]; Available from:

https://europepmc.org/article/NBK/nbk544299

3. de Carbonnières A, Challine A, Cottereau AS, Coriat R, Soyer P, Abou Ali E, et al. Surgical management of insulinoma over three decades. HPB 2021; 23(12): 1799–1806.

https://doi.org/10.1016/j.hpb.2021.04.013

4. Santos VR, Ramos C, Cruz R, Barão A, Miranda C, Coutinho J. Surgical Treatment of Pancreatic Insulinomas: A Series of 15 Years. J Cancer Res Rev Rep 2021; 3: 145.

https://doi.org/10.47363/JCRR/2021

5. Xu Q, Xie Q, Ge C, Zou X, Gao R, Liu Q, et al. Risk factors and prevention of postoperative pancreatic fistula after insulinoma enucleation:a retrospective study from a high-volume center. Pancreatology 2021; 21(6): 1208–1215.

https://doi.org/10.1016/j.pan.2021.06.001

6. Heeger K, Falconi M, Partelli S, Waldmann J, Crippa S, Fendrich V, et al. Increased rate of clinically relevant pancreatic fistula after deep enucleation of small pancreatic tumors. Langenbecks Arch Surg 2014; 399(3): 315–321. https://doi.org/10.1007/s00423-014-1171-0

7. Lou I, Inabnet III WB. Advances in the Diagnosis and Management of Insulinoma. Advances in treatment and management in Surgical Endocrinology (Elsevier 2020). Chapter 18: 199-206.https://doi.org/10.1016/B978-0-323-66195-9.00018-2

8. Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery 2017; 161(3): 584–591.

https://doi.org/10.1016/j.surg.2016.11.014

9. Pindura M, Nosáková L, Kyčina R, Vojtko M, Bánovčin P, Demeter M, et al. Preoperative stenting in insulinoma located nearby pancreatic duct: a case report and literature review. J Surg Case Rep 2021; 2021(4): rjab121.

https://doi.org/10.1093/jscr/rjab121

10. Nahm CB, Connor SJ, Samra JS, Mittal A. Postoperative pancreatic fistula: a review of traditional and emerging concepts. Clin Exp Gastroenterol 2018; 11(1): 105–118.

https://doi.org/10.2147/CEG.S120217