Laparoscopic Localization and Resection of Insulinomas

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Abstract
Insulinoma is the most common functional neuroendocrine tumor of the pancreas,1,2 with an incidence of 4 per million person-years.3 Patients often initially have symptoms of neuroglycopenia (eg, confusion, somnolence, and visual disturbances) and hypoglycemia-induced catecholamine release (eg, tachycardia, sweating, and tremor). Diagnosis is confirmed biochemically during a supervised 72-hour fast. A diagnosis of insulinoma is made in symptomatic patients who demonstrate hypoglycemia, an inappropriate insulin level, and increased concentrations of C peptide.1,3 Plasma screening results for both classes of sulfonylureas must be negative during end-of-fast studies.