Laparoscopic Distal Pancreatectomy for a Glucose-responsive Insulinoma

A 57-year-old woman presented hypoglycemia during or after a meal. The laboratory findings, including endocrine hormone levels were within the normal range, but the 75 g-oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (ivGTT) indicated excessive insulin secretion and hypogl...

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Published inThe Japanese Journal of Gastroenterological Surgery Vol. 50; no. 6; pp. 445 - 453
Main Authors Asano, Daisuke, Ozawa, Naoko, Matsuda, Yusuke, Nishio, Yuichirou, Yuan, Bee, Baba, Hironobu, Kondo, Ito, Murayama, Tadao, Hoshino, Naoaki, Ono, Chihiro, Nishioka, Yoshinobu
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 01.06.2017
Subjects
arterial stimulation and venous sampling
glucose-responsive insulinoma
intraoperative ivGTT
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Abstract A 57-year-old woman presented hypoglycemia during or after a meal. The laboratory findings, including endocrine hormone levels were within the normal range, but the 75 g-oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (ivGTT) indicated excessive insulin secretion and hypoglycemia. A starvation test showed no excessive insulin secretion. Dynamic CT showed a solitary tumor in the pancreatic tail, which was diagnosed as a glucose-responsive insulinoma. Angiography and arterial stimulation venous sampling results supported this diagnosis and showed no metastasis. We performed a laparoscopic spleen-preserving distal pancreatectomy. Additionally, we performed intraoperative ivGTT post-resection that indicated normoglycemia and normal insulin secretion, confirming the absence of residual tumor. To the best of our knowledge, this is the first report of an intraoperative GTT. Hence, we report a rare case of glucose-responsive insulinoma and the usefulness of intraoperative GTT.
AbstractList A 57-year-old woman presented hypoglycemia during or after a meal. The laboratory findings, including endocrine hormone levels were within the normal range, but the 75 g-oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (ivGTT) indicated excessive insulin secretion and hypoglycemia. A starvation test showed no excessive insulin secretion. Dynamic CT showed a solitary tumor in the pancreatic tail, which was diagnosed as a glucose-responsive insulinoma. Angiography and arterial stimulation venous sampling results supported this diagnosis and showed no metastasis. We performed a laparoscopic spleen-preserving distal pancreatectomy. Additionally, we performed intraoperative ivGTT post-resection that indicated normoglycemia and normal insulin secretion, confirming the absence of residual tumor. To the best of our knowledge, this is the first report of an intraoperative GTT. Hence, we report a rare case of glucose-responsive insulinoma and the usefulness of intraoperative GTT.
Author Baba, Hironobu
Matsuda, Yusuke
Yuan, Bee
Nishioka, Yoshinobu
Ozawa, Naoko
Ono, Chihiro
Asano, Daisuke
Nishio, Yuichirou
Hoshino, Naoaki
Kondo, Ito
Murayama, Tadao
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  fullname: Asano, Daisuke
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Ozawa, Naoko
  organization: Department of Internal Medicine of Endocrinology and Metabolism, Soka Municipal Hospital
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  fullname: Matsuda, Yusuke
  organization: Department of Internal Medicine of Endocrinology and Metabolism, Soka Municipal Hospital
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  fullname: Nishio, Yuichirou
  organization: Department of Internal Medicine of Endocrinology and Metabolism, Soka Municipal Hospital
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  fullname: Yuan, Bee
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  fullname: Baba, Hironobu
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Kondo, Ito
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Murayama, Tadao
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Hoshino, Naoaki
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Ono, Chihiro
  organization: Department of Surgery, Soka Municipal Hospital
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  fullname: Nishioka, Yoshinobu
  organization: Department of Surgery, Soka Municipal Hospital
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Snippet A 57-year-old woman presented hypoglycemia during or after a meal. The laboratory findings, including endocrine hormone levels were within the normal range,...
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StartPage 445
SubjectTerms arterial stimulation and venous sampling
glucose-responsive insulinoma
intraoperative ivGTT
Title Laparoscopic Distal Pancreatectomy for a Glucose-responsive Insulinoma
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