Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI).

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Gimm, OliverDepartment of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, Germany (författare)

Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI).

Artikel/kapitelEngelska2007

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2007-02-09
Springer Science and Business Media LLC,2007
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:liu-101873
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-101873URI
https://doi.org/10.1007/s00423-006-0144-3DOI

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Språk:engelska
Sammanfattning på:engelska

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BACKGROUND AND AIMS: Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor. In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until recently.MATERIALS AND METHODS: Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial calcium injection (SACI). In addition, insulin was measured before surgery and every 10-15 min after resection of the tumor using a quick insulin assay.RESULTS: Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected (n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively, underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped to normal levels within 20 min in all cases. After a follow-up of 0.8-3 years, all patients remained biochemically cured.CONCLUSIONS: Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted using a quick insulin assay.

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König, EvelynDepartment of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, Germany (författare)
Thanh, Phuong NguyenDepartment of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, Germany (författare)
Brauckhoff, MichaelDepartment of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, Germany (författare)
Karges, WolframDivision of Endocrinology, University of Ulm, Ulm, Germany (författare)
Dralle, HenningDepartment of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, Germany (författare)
Department of General, Visceral and Vascular Surgery, University of Halle, Ernst-Grube-Str. 40, 06097, Halle, GermanyDivision of Endocrinology, University of Ulm, Ulm, Germany (creator_code:org_t)

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Ingår i:Langenbeck's archives of surgery (Print): Springer Science and Business Media LLC392:6, s. 679-841435-24431435-2451

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Av författaren/redakt...: Gimm, Oliver; König, Evelyn; Thanh, Phuong Ng ...; Brauckhoff, Mich ...; Karges, Wolfram; Dralle, Henning

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