What is included in preoperative management of insulinoma?

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

Preoperative management is as follows:

  • Administer diazoxide on the day of surgery in patients who respond to it. Diazoxide reduces the need for glucose supplements and the risk of hypoglycemia.

  • Monitor blood glucose level throughout surgery.

  • Infuse 10% dextrose in water at a rate of at least 100 mL/h.

  • A preoperative trial with diazoxide is indicated to determine whether the patient is a responder (5-10% of patients do not respond); the trial results help determine the intraoperative strategy if the tumor is not localized.

  • In patients with multiple endocrine neoplasia type 1 (MEN 1), hypercalcemia must be corrected first by parathyroidectomy before insulinoma resection. [52]


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