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Laparoscopic enucleation of a solitary insulinoma located in the isthmus of the pancreas

B Dallemagne, MD J D'Agostino, MD L Marx, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Apr 2012;12(04). URL: http://websurg.com/doi/vd01en3402

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  • 2012-04-16
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The majority of insulinomas are benign, solitary, and are located within the pancreatic parenchyma. Because of the characteristic clinical presentation of hypoglycemia, they are usually diagnosed when they are still small (<20mm in size) and resectable. Approximately 10% of insulinomas are malignant. Surgical resection is preferred for insulinomas and cure is achieved in more than 90% of the patients. Surgical procedures include tumor enucleation, partial or total pancreatic resection, and pancreatoduodenectomy (Whipple’s operation). Enucleation is indicated for small, benign lesions located at least 2 to 3mm from the main pancreatic duct. This video presents a laparoscopic enucleation of a solitary, presumably benign insulinoma located in the isthmus of the pancreas in a young female patient presenting with typical symptoms evocative of Whipple's triad.