Abstract
BackgroundInsulinomas are rare tumors, in the majority of cases best treated by surgical resection. Preoperative localization of insulinoma is challenging. The more precise the preoperative localization the less invasive and safer is the resection. The purpose of the study is to check the impact of a new technique to localize insulinoma on the surgical strategy.FindingsWe present exact preoperative localization with Glucagon-like peptide-1 receptor (GLP-1R) imaging. This allows a more precise resection thereby reducing surgical access trauma, loss of healthy pancreatic tissue and increasing safety and quality of the surgical intervention.ConclusionWith the help of precise preoperative localization of insulinoma with GLP-1R imaging the surgeon is able to minimize the amount of resected healthy pancreatic tissue. We hypothesize that GLP-1R imaging will become a preoperative diagnostic tool to be used for many patients scheduled for open or laparoscopic insulinoma resection.
Highlights
Precise preoperative localization of insulinoma is challenging
With the help of precise preoperative localization of insulinoma with Glucagon-like peptide-1 receptor (GLP-1R) imaging the surgeon is able to minimize the amount of resected healthy pancreatic tissue
We hypothesize that GLP-1R imaging will become a preoperative diagnostic tool to be used for many patients scheduled for open or laparoscopic insulinoma resection
Summary
Precise preoperative localization of insulinoma is challenging. In a recent systematic review computed tomography (CT) is described as diagnostic modality of choice and reaches a rate of correct localization of 44.4% [1]. Magnetic resonance imaging (MRI) is an accepted alternative with a rate of correct localization of 47.4%. With intraoperative ultrasound insulinomas of a size of 2-3 mm can be detected [2]. The rate of correct localization was reviewed as 91.5% with a mean sensitivity of 91.2%. Open (or laparoscopic) surgical exploration combined with intraoperative ultrasound remains the preferred. The more precise the preoperative localization the less invasive and safer is the resection. The purpose of the study is to check the impact of a new technique to localize insulinoma on the surgical strategy
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