American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: Editor-in-chief: Nabil Abdel-Hamid
Open Access
Journal Browser
American Journal of Cancer Prevention. 2016, 4(1), 8-12
DOI: 10.12691/ajcp-4-1-2
Open AccessCase Report

Diagnosis and Surgical Treatment of Insulinoma in Sixteen Cases

Cheng Wei1, Xu Xuesong2 and Gong Jianping2,

1Surgery Department, Chongqing Yubei District Tranditional Chinese Medicine Hospital, Chongqing, China

2Heptobiliary Surgery Department, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Pub. Date: March 23, 2016

Cite this paper:
Cheng Wei, Xu Xuesong and Gong Jianping. Diagnosis and Surgical Treatment of Insulinoma in Sixteen Cases. American Journal of Cancer Prevention. 2016; 4(1):8-12. doi: 10.12691/ajcp-4-1-2


Backgroud: Insulinoma is a rare tumor derived from B cells of pancreas islets, while recently, according to some researches, the incidence of insulinoma is increasing. It is believed that much more attention should be attached to the diagnosis and treatment of insulinoma. The goal of this retrospective study was to analyze the strategy for the surgical management of insulinomas. Methods: From May 2001 to October 2010, the medical records of 16 patients with insulinomas were included in our studied. We confirmed the diagnosis accoringd to a series of biochemical tests. Then all tumors were localized precisely by imaging techniques combined with intraoperative palpation. Except 4 patients who denied surgical treatment, all these patients was accepted follow-up after operation. Result: 11 patients with benign lesions underwent open surgical. 1 patient with malignant insulinomas underwent pancreaticoduodenectomy. The mean hospital stay was 17.0 ± 6.0 days after after the open procedures. 14 complications occurred in 7 patients following resection. On follow-up, 92% of the patients were free from symptoms, and surgical cure was achieved in 95% of the patients with benign insulinomas. Conclusion: The choice of the surgical strategy for the treatment of pancreatic insulinomas depends on size and location of the tumor and the risk of malignancy. The optimal surgical procedure is key to prevent postoperative complications.

insulinoma whipple triad blood glucose lever localization diagnosis treatment

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Halfdanarson TR, Rabe KG, Rubin J, et al. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol, 19(10). 1727-1733. 2008.
[2]  Zhao YP, Zhan TP, et al. Surgical management of patients with insulinomas: Result of 292 cases in a single institution[J]. J Surg Oncol, 103(2). 169-174. 2011.
[3]  Zhou JS, Jiang Y, Wu BQ, et al. Diagnose and treatment experience about 10 Cases of Insulinoma. Journal of Hepatopancreatobilaary Surgery, 22. 500-501. 2010.
[4]  Alexakis N, Neoptolemos JP. Pancreatic neuroendocrine tumours. Best Pract Res Clin Gastroenterol 22(1). 183-205. 2008.
[5]  De Herder WW, Niederle B, Scoazec JY, et al. Well-differentiated pancreatic tumor/carcinoma: insulinoma. Neuroendocrinology, 84(3). 183-188. 2006.
[6]  Muro S, Nasu J, Harada R, et al. Prompt resolution of hypoglycemia by hepatic transarterial embolization for malignant insulinoma with multiple liver metastasis[J]. Acta Med Okayama, 68(5). 303-306. 2014.
[7]  Garbrecht N, Anlauf M, Schmitt A, et al. Somatostatin-producing neuroendocrine tumors of the duodenum and pancreas: incidence, types, biological behavior, association with inherited syndromes, and functional activity. Endocr Relat Cancer, 15(1). 229-241. 2008
[8]  O'Toole D, Salazar R, Falconi M, et al. Rare functioning pancreatic endocrine tumors. Neuroendocrinology, 84(3). 189-195. 2006
[9]  Ehehalt F, Saeger HD, Schmidt CM, et al. Neuroendocrine tumors of the pancreas. Oncologist, 14(5). 456-467. 2009
[10]  Hu WY, Guo WD, KongJ, et al. Diagnose and treatment of Insulinoma. Journal of Abdominal, Surgery, 27(3). 200-202. 2014.
[11]  Zhang N, Qiu XG. Surgical diagnosis and treatment of insulinoma. International Journal of Surgery, 42(3). 174-176. 2015.
[12]  Han JF, Zhang F, Bao YQ, et al. Clinical significance of glycometabolism-related indexes for diagnosis of insulinoma. Chinese Medical Journal, 90(16). 1093-1096. 2010.
[13]  Sun WY, Guo DW, Jiang XF, et al. Application experience about the role of ultrasound localization in surgical treatment of insulinoma. Journal of Modern Oncology, 19(8). 1605-1607. 2011.
[14]  Long X, Li Y, Wang X, Ouyang Y, et al. Retrospective analysis of preoperative localization of insulinomas on CT. Zhong Nan Da Xue Xue Bao Yi Xue Ban, 34(2). 165-171. 2009.
[15]  Fidler JL, Fletcher JG, Reading CC, et al. Preoperative detection of pancreatic insulinomas on multiphasic helical CT. AJR Am J Roentgenol, 181(3). 775-780. 2003.
[16]  Ichikawa T, Peterson MS, Federle MP, et al. Islet cell tumor of the pancreas: biphasic CT versus MR imaging in tumor detection. Radiology , 216(1). 163-171. 2000.
[17]  Erturk SM, Ichikawa T, Motosugi U, et al. Diffusion-weighted MR imaging in the evaluation of pancreatic exocrine function before and after secretin stimulation. Am J Gastroenterol, 101(1). 133-136. 2006.
[18]  Anaye A, Mathieu A, Closset J, et al. Successful preoperative localization of a small pancreatic insulinoma by diffusion-weighted MRI. JOP , 10(5). 528-531. 2009.
[19]  Anderson MA, Carpenter S, Thompson NW, et al. Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol , 95(9). 2271-2277. 2000.
[20]  Sotoudehmanesh R, Hedayat A, Shirazian N, et al. Endoscopic ultrasonography (EUS) in the localization of insulinoma. Endocrine , 31(3). 238-241. 2007.
[21]  Wu HS, Zhang JJ, Xiong JQ, et al. Diagnosis and treatment analysis and clinical features of nonfunctional insulinoma. Chinese Journal of General Surgery, 18(8). 843-846. 2009.
[22]  Sharma P, Singh H, Bal C, et al. PET/CT imaging of neuroendocrine tumor with (68) Gallium-Labeled somatostatin analogues: an overview and single institution experience from India[J]. Indian J Med, 29(1). 2-12. 2014.
[23]  Wild D, Wicki A, Mansi R, et al. Exendin-4-based radiopharmaceuticals for glucagon-like peptide 1 receptor PET/CT and SPECT/CT[J]. J Nucl Med, 51(7). 1059-1067. 2010.
[24]  Geng C, Ma SZ, Wang XY, et al. Accurate rescetion of functional insulinoma. Chinese Journal of General Surgery, 22(3). 329-332. 2013.
[25]  Okabayashi T, Shima Y, Sumiyoshi T, et al. Diagnosis and management of Insulinoma. World J Gastroenterol, 32. 176-178. 2013.
[26]  Service FJ, McMahon MM, O'Brien PC, et al. Functioning insulinoma--incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc, 66(7). 711-719. 1991
[27]  Grant CS: Insulinoma. Best Pract Res Clin Gastroenterol, 19(5). 783-798. 2005.
[28]  Levy MJ, Thompson GB, Topazian MD, et al. US-guided ethanol ablation of insulinoma: a new treatment option[J]. N Engl J Med, 360(2). 195-197. 2009.
[29]  Fiebrich HB, Siemerink EJ, Brouwers AH, et al. Everolimus induced rapid plasma glucose Nomalization in insulinoma patients by effects on tumor as well as normal tissue[J]. Oncologist, 16(6). 783-787. 2011.
[30]  Arianeb M, Lars F, Mohammadreza H, et al. a Systematic review of location ,surgical treatment option and outcome of insulinoma. Pancreas, 43. 675-686. 2014.
[31]  Espana G, Velazquez FD, Bezaury P, et al. Pancreatic insulinoma: a surgical experience. World J Surg, 7. 150-156. 2009.