What are the surgical options for treatment of insulinoma?

Updated: May 31, 2020
  • Author: Zonera Ashraf Ali, MBBS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Laparoscopic surgery: A large study from Spain showed laparoscopic surgery to be safe and effective in benign and malignant tumor resection [8]

Enucleation: Because of the small likelihood that a tumor that presents without metastatic spread is malignant, insulinomas may be removed by enucleation

Pancreaticoduodenectomy: If enucleation is not possible, a larger pancreatic resection, including pancreaticoduodenectomy, may be necessary

Whipple procedure: Major resections, such as the Whipple procedure, may become necessary when the tumor is found in the pancreatic head and local excision is not possible

Subtotal pancreatectomy with enucleation: If insulinoma is associated with multiple endocrine neoplasia type 1 (MEN1), subtotal pancreatectomy with enucleation of tumors from the pancreatic head and uncinate processus often is recommended over simple enucleation, because of frequent multiple tumors in MEN1

Even when metastases are found, surgical excision is often feasible before any medical, chemotherapeutic, or other interventional therapy is considered. Resect all gross disease; this would include performing wedge resections of hepatic metastases

See Treatment and Medication for more detail.


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