Objective: To summarize the experience in the diagnosis and treatment of insulinoma.
Methods: We retrospectively reviewed 220 patients with insulinoma confirmed surgically in the PUMC Hospital from 1953 to 1999. They were 131 men and 89 women, aged on average 39 years.
Results: In the 220 patients, the average interval from the onset of symptoms to diagnosis was 35 months. 54% of the patients were misdiagnosed before admission to the hospital. In 214 patients underwent operation, 201 (93.9%) had benign tumor and 12 (5.6%) malignant one. The diameter of 78% tumors was less than 2cm. 90.7% tumors were single and 9.3% were multiple. 37.1% tumors were located in the head and uncinate process of the pancreas, 26.1% in the body, 36.1% in the tail, and 0.7% ectopic. 95.5% patients had Whipple's triad and the ratio of insulin to glucose was greater than 0.3 in 89% patients. The positive rates of B-ultrasound, CT and MRI for localization before operation were low, but those of angiography and PTPC were 62.8% and 88% respectively. Most patients could be cured by simple enucleation of tumor. The main complications were pancreatic fistulae and pancreatitis.
Conclusion: It is important for surgeons to familiarize with insulinoma, the most common islet cell tumor, for a better treatment.