In:
ANZ Journal of Surgery, Wiley, Vol. 86, No. 9 ( 2016-09), p. 706-710
Abstract:
Insulinoma is a rare functional pancreatic neuroendocrine tumour ( NET ) believed to have an excellent long‐term outcome, but few studies have solely focused on this issue after apparently curative resection. This study aimed to assess post‐operative and long‐term outcomes after resection of benign insulinomas. Methods From 1998 to 2013, 36 consecutive patients with insulinomas underwent surgery. Three patients had multiple endocrine neoplasia type‐1 ( MEN ‐1). Demographics, operative findings, tumour grade (2010 World Health Organization ( WHO ) NET classification), post‐operative pancreatic fistula ( POPF ) grade (International Study Group of Pancreatic Fistula ( ISGPF )), complications and recurrence were analysed. Results Eighteen (50%) had enucleation while the rest underwent pancreatic resection. The majority (86.1%) of insulinomas belonged to WHO NET grade G1 . POPF occurred in 58.3% of patients while clinical fistula ( ISGPF grades B and C) occurred in 19.4%. One (2.8%) patient required reoperation. The occurrence of POPF was not related to type of resection or surgical approach. There was no perioperative mortality. After a mean follow‐up of 83.6 months, two patients (5.7%) developed disease recurrence at 34.4 and 131.9 months after initial surgery. No patients developed distant metastasis. The 10‐ and 15‐year disease‐free rates were 95.6 and 85.4%, respectively. Conclusion POPF occurred frequently and posed a significant morbidity after resection of insulinoma. However, it occurred independently of type of resection or surgical approach. Although the immediate cure rate after resection was high (100%), long‐term disease recurrence in sporadic (non‐ MEN ‐1) cases was not insignificant. Regular long‐term follow‐up is recommended.
Type of Medium:
Online Resource
ISSN:
1445-1433
,
1445-2197
DOI:
10.1111/ans.2016.86.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2095927-8
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