caa a22 4500 475791118 CHVBK 20180406123711.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s004230000148 doi (NATIONALLICENCE)springer-10.1007/s004230000148 Therapeutic experience of 65 cases with organic hyperinsulinism [Elektronische Daten] [Per Hellman, Peter Goretzki, Dietmar Simon, Cornelia Dotzenrath, Hans D Röher] Abstract.: Introduction: The treatment for insulinoma is enucleation or resection, which are associated with various degrees of morbidity, including fistulas, pseudocysts, and necessity for reoperations. Patients: We evaluated the outcome of 65 patients operated on for organic hyperinsulinism at an experienced university hospital (Department of Surgery, Heinrich-Heine University, Düsseldorf, Germany) between 1990 and 1998. Procedures included enucleation (n=37), left-sided resection (n=19), combination of enucleation from the head and left-sided resection (n=4), subtotal left pancreatectomy (n=2), and pancreaticoduodenectomy (n=3). Results: In 47 out of the 65 patients (72%), the expected benign solitary insulinoma was found. Seven patients had malignant tumors and another eight had multiple tumors (including two with multiple endocrine neoplasia type 1 (MEN-1)), and three had nesidioblastosis. In total, 20 patients (31%) developed postoperative drainage of high amylase containing fluid, which in all but three cases resolved with conservative therapy. The three patients who developed fistulas and the three patients who developed pseudocysts underwent reoperative surgery. Seventeen (41%) of the patients who underwent enucleation (10 from the pancreatic head; 50%) and six (25%) of the resected patients demonstrated these complications. Postoperative glucose metabolism was normalized in all patients. Conclusion: Resection, especially in the head of the pancreas, demonstrates lower complication rates than enucleation. We propose resection for tumors that are large, malignant, situated close to pancreatic duct, and are multiple, including in MEN-1. For tumors in the head, pancreaticoduodenectomy may be an occasional choice. Springer-Verlag, 2000 Pancreaticoduodenectomy Fistula Pseudocyst MEN-1 Nesidioblastosis nationallicence Hellman Per Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut Goretzki Peter Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut Simon Dietmar Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut Dotzenrath Cornelia Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut Röher Hans D. Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut https://doi.org/10.1007/s004230000148 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000148 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hellman Per Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Goretzki Peter Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Simon Dietmar Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Dotzenrath Cornelia Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Röher Hans D. Department of Surgery, Heinrich-Heine University, Moorenstrasse 5, D-40225, Düsseldorf, Germany aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer