علاج ورم الأنسولينوما الموضعي المقتصر على البنكرياس دون مرض نقيلي

References

DOI: 10.1111/jne.13318

Surgical resection is the gold standard treatment for localised insulinomas.

Parenchyma-sparing pancreatic resections should be proposed as first-line surgical strategy, when technically feasible.

Enucleation can be proposed to patients with insulinomas smaller than 2–3 cm and located at ≥3 mm from the MPD.

Central pancreatectomy represents a valuable option for patients with insulinomas located in the pancreatic neck, when enucleation is not feasible, and the remaining parenchyma is enough to guarantee a relevant pancreatic function.

Therefore, a minimally invasive approach should be always considered, when technically feasible, for patients with preoperatively localised insulinomas.

On the other hand, open surgery with intraoperative ultrasound is required when insulinomas are not localised preoperatively.

EUS-RFA might be considered as treatment option in patients with small (≤2 cm) localised insulinomas considered as unfit for surgery.