Hypoglycemia surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hypoglycemia}} | {{Hypoglycemia}} | ||
{{CMG}} | {{CMG}} {{AE}} {{MAD}} | ||
==Overview== | ==Overview== | ||
Surgical treatment is reserved for [[insulinoma]]. | |||
Surgical removal of the | Surgical removal of the [[insulinoma]] is the treatment of choice and resection of [[metastatic]] [[Liver diseases|liver disease.]] | ||
==Surgery== | ==Surgery== | ||
Surgical treatment is reserved for the cases where the cause of hypoglycemia is [[insulinoma]]. | |||
* Surgical removal of the insulinoma is the treatment of choice:<ref name="pmid1677058">{{cite journal| author=Service FJ, McMahon MM, O'Brien PC, Ballard DJ| title=Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. | journal=Mayo Clin Proc | year= 1991 | volume= 66 | issue= 7 | pages= 711-9 | pmid=1677058 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1677058 }}</ref> | |||
**[[Enucleation]] of the [[insulinoma]]: Removal of the [[mass]] out of the [[pancreas]] with thin margins between tumor and [[pancreas]] | |||
**Partial distal [[pancreatectomy]]: In this procedure, body and tail of the [[pancreas]] are removed.<ref name="pmid23430217">{{cite journal| author=Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y et al.| title=Diagnosis and management of insulinoma. | journal=World J Gastroenterol | year= 2013 | volume= 19 | issue= 6 | pages= 829-37 | pmid=23430217 | doi=10.3748/wjg.v19.i6.829 | pmc=3574879 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23430217 }}</ref> | |||
**Distal subtotal [[pancreatectomy]] is recommended for patients with insulinoma related to [[MEN1]].<ref name="pmid1684067">{{cite journal| author=Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH| title=Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach. | journal=Surgery | year= 1991 | volume= 110 | issue= 6 | pages= 998-1004; discussion 1004-5 | pmid=1684067 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1684067 }}</ref> | |||
* Recurrence is more common in the patients with [[MEN1]]. | |||
* Hepatic resection is indicated for the treatment of [[metastatic]] [[Liver diseases|liver disease]] if the general condition is good. Resection should be considered only for patients with a limited number of hepatic metastases.<ref name="pmid12081066">{{cite journal| author=Hirshberg B, Libutti SK, Alexander HR, Bartlett DL, Cochran C, Livi A et al.| title=Blind distal pancreatectomy for occult insulinoma, an inadvisable procedure. | journal=J Am Coll Surg | year= 2002 | volume= 194 | issue= 6 | pages= 761-4 | pmid=12081066 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12081066 }}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 14:48, 17 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Surgical treatment is reserved for insulinoma. Surgical removal of the insulinoma is the treatment of choice and resection of metastatic liver disease.
Surgery
Surgical treatment is reserved for the cases where the cause of hypoglycemia is insulinoma.
- Surgical removal of the insulinoma is the treatment of choice:[1]
- Enucleation of the insulinoma: Removal of the mass out of the pancreas with thin margins between tumor and pancreas
- Partial distal pancreatectomy: In this procedure, body and tail of the pancreas are removed.[2]
- Distal subtotal pancreatectomy is recommended for patients with insulinoma related to MEN1.[3]
- Recurrence is more common in the patients with MEN1.
- Hepatic resection is indicated for the treatment of metastatic liver disease if the general condition is good. Resection should be considered only for patients with a limited number of hepatic metastases.[4]
References
- ↑ Service FJ, McMahon MM, O'Brien PC, Ballard DJ (1991). "Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study". Mayo Clin Proc. 66 (7): 711–9. PMID 1677058.
- ↑ Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y; et al. (2013). "Diagnosis and management of insulinoma". World J Gastroenterol. 19 (6): 829–37. doi:10.3748/wjg.v19.i6.829. PMC 3574879. PMID 23430217.
- ↑ Demeure MJ, Klonoff DC, Karam JH, Duh QY, Clark OH (1991). "Insulinomas associated with multiple endocrine neoplasia type I: the need for a different surgical approach". Surgery. 110 (6): 998–1004, discussion 1004-5. PMID 1684067.
- ↑ Hirshberg B, Libutti SK, Alexander HR, Bartlett DL, Cochran C, Livi A; et al. (2002). "Blind distal pancreatectomy for occult insulinoma, an inadvisable procedure". J Am Coll Surg. 194 (6): 761–4. PMID 12081066.