How is an insulinoma removed?

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The 2 choices for the method of surgical removal of the insulinoma are enucleation or pancreatic resection

In enucleation, the consistency of the insulinoma is usually a very compact ball of cells, usually more firm than the surrounding pancreas tissue. The interface between the insulinoma and pancreas tissue is usually clearly visible, and can be dissected cleanly by the surgeon, assuring that the entire tumor is removed. Sometimes, even when the tumor sits against the main pancreatic duct, the 2 can be separated without injury to the duct (Figure 1). However, if the tumor is large, or if the relationship between the duct and the tumor is difficult, then duct injury can be a major risk. In such a situation, it may be preferable to remove some normal pancreas with the insulinoma within it, and manage the pancreatic duct separately.

In pancreatic, resection, the location of the tumor within different regions of the pancreas may influence the conduct of the operation considerably. The head of the pancreas is so inter-attached to many other anatomic structures, that resection (Whipple procedure) carries a very significant chance of complications (40% at least) even if the tumor is successfully removed. In contrast, the tail of the pancreas, while close to the spleen, can be removed much more safely (either with or without removing the spleen).
 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.