A Report of Four Cases of Insulinoma

This is the authors' abstract. We don't add key points for this paper.

By December 1986, four patients with Insulinoma were admitted to our hospital. All the patients, a man and three women, complined of unconciousness on fasting. The age range was 22-68 years (mean, 39.5 years). They were diagnosed as insulinoma by laboratory examinatin. To determine the localization of tumors we used ERCP, US, pancratic scintigraphy, angiography and CT scan. Although the site of the tumor was identified in three cases by angiography, in one of them the tumor stain was obscure. We then applied percutaneous trnshepatic portal-venous sampling (PTPVS) to confirm the site of tumor. This procedure demonstrated stepped up insulin at the superior pancreatoduodenal vein. The other method did not demonstrate the localization of tumors in four cases. Enucleation in two cases, distalpancreatectomy and pancreatoduodenctomy were performed in one case each. Bilialy fistula and pancreatic fistula were complications but were treated conservatively. Three of the four patients (one woman's prognosis is unknown) have shown a good course.