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Diagnostic monitoring of plasma levels of glucose and insulin during surgery for insulinoma

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Abstract

With serial measurement of blood sugar levels during surgery in three patients with solitary insulinoma, we confirmed the location, then later, the complete elimination of the insulin-secreting tumor. Following virgorous massage of the tumor, blood sugar levels decreased while the levels progressively increased within 20 min following removal of the tumor. Subsequent measurement of simultaneous plasma insulin levels provided further confirmation. Plasma levels of insulin increased in accordance with massage of the tumor. Prior to removal of the tumor, the levels progressively decreased to less than the preoperative levels. For success in detecting slight changes in blood sugar levels secondary to increase or decrease of insulin secretion during surgery for insulinoma, (1) controlled infusion of glucose to keep blood sugar levels around 80 mg/dl and (2) frequent rapid determination of blood sugar levels are considered to be important.

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References

  1. Stefanini, P., Carboni, M., Patrassi, N. and Bassoli, A.: Beta-islet cell tumors of the pancreas: Results of a study on 1,067 cases. Surgery 75: 597, 1974.

    PubMed  CAS  Google Scholar 

  2. Filipi, C. J. and Higgins, G. A.: Diagnosis and management of insulinoma. Am. J. Surg. 125: 231, 1973.

    Article  PubMed  CAS  Google Scholar 

  3. Kawamori, T., Shichiri, M., Goriya, Y. Yamasaki, Y., Shigeta, Y. and Abe, H.: Importance of insulin secretion based on the rate of change in blood glucose concentration in glucose tolerance, assessed by the artificial beta cell. Acta Endocrinol. 87: 339, 1978.

    PubMed  CAS  Google Scholar 

  4. Sayer, A. and Gerstenfeld, S.: The photometric microdetermination of blood glucose with glucose oxidase. J. Lab. Clin. Med. 51: 4488, 1958.

    Google Scholar 

  5. Hales, C. N. and Randle, P. J.: Immuno-assay of insulin with insulin-antibody precipitate. Biochem. J. 88: 137, 1963.

    PubMed  CAS  Google Scholar 

  6. McMillan, F. L. and Scheibe, J. R.: Islet cell tumor of the pancreas. Am. J. Surg. 82: 759, 1951.

    Article  PubMed  CAS  Google Scholar 

  7. Madsen, B. and Hansen, E. S.: Correlation between angiographic diagnosis and histology of pancreatic insulinoma. Brit. J. Radiol. 143: 185, 1970.

    Article  Google Scholar 

  8. Fulton, R. E., Sheedy, P. F. II, McIlrath, D. C. and Ferris, D. O.: Preoperative angiographic localization of insulin-producing tumors of the pancreas. Am. J. Radiol. 123: 367, 1975.

    CAS  Google Scholar 

  9. Ferris, D. O., Molnar, G. D., Schnelle, N., Jones, J. D. and Moffit, E. A.: Recent advances in management of functioning islet cell tumor. Arch. Surg. 104: 443, 1972.

    PubMed  CAS  Google Scholar 

  10. Chari, P., Pandit, S. K., Kataria, R. N., Singh, H., Baheti, D. K. and Wig, J.: Anesthetic management of insulinoma. Anesthesia 32: 216, 1977.

    Google Scholar 

  11. Gentzen, L. C. and Sode, J.: Rapid detection of hyperglycemic rebound in insulinoma surgery. Surgery 61: 868, 1967.

    Google Scholar 

  12. Aono, K., Kato, T., Nakamura, Y., Imaizumi, N., Koga, A. and Takagi, A.: Changes in glucose tolerance and insulin secretion during surgery in patients with hyperinsulinemia. J. Jpn. Diab. Soc. 18: 591, 1975. (English Abst.)

    Google Scholar 

  13. Tutt, G. O. Jr., Edis, A. J., Service, F. J. and Van Heerden, J. A.: Plasma glucose monitoring during operation for insulinoma: A critical reappraisal. Surgery 88: 351, 1980.

    PubMed  Google Scholar 

  14. Rich, R. H., Dehner, L. P., Okinaga, K., Deeb, L. C., Ulstrom, R. A. and Leonard, A. S.: Surgical management of islet-cell adenoma in infancy. Surgery 84: 519, 1978.

    PubMed  CAS  Google Scholar 

  15. Harrison, T. S., Child, C. G. III, Fry, W., Floyd, J. Jr. and Fajans, S. S.: Current surgical management of functioning islet cell tumor of the pancreas. Ann. Surg. 178: 485, 1973.

    PubMed  CAS  Google Scholar 

  16. Miller, D. R.: Functioning adenomas of pancreas with hyperinsulinism. Arch. Surg. 90: 509, 1965.

    PubMed  CAS  Google Scholar 

  17. Fonkalsrud, E. W., Dilley, R. B. and Longmire, W. P. Jr.: Insulin secreting tumor of the pancreas. Ann. Surg. 159: 730, 1964.

    PubMed  CAS  Google Scholar 

  18. Kawamori, R., Tohdo, R., Yamasaki, Y., Shimizu, Y., Shichiri, M., Abe, H., Miyata, M., Sakamoto, T., Sakaguchi, H. and Nakao, K.: Intraoperative localization of an occult insulinoma using an artificial endocrine pancreas applying glucose infusion rate as the index. J. Jpn. Diab. Soc. 23: 851, 1980. (English Abst.).

    Google Scholar 

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Authors and Affiliations

  1. The First Department of Surgery, Osaka University Medical School, 1-1-50 Fukushima, Fukushima-ku, 553, Osaka, Japan

    Masahiko Miyata, Hiromasa Sakaguchi, Tsukuru Hashimoto, Masaaki Izukura, Masayasu Hamaji, Kazuyasu Nakao & Yasunaru Kawashima

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  1. Masahiko Miyata
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  2. Hiromasa Sakaguchi
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  3. Tsukuru Hashimoto
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  4. Masaaki Izukura
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  5. Masayasu Hamaji
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  6. Kazuyasu Nakao
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  7. Yasunaru Kawashima
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Miyata, M., Sakaguchi, H., Hashimoto, T. et al. Diagnostic monitoring of plasma levels of glucose and insulin during surgery for insulinoma. The Japanese Journal of Surgery 13, 285–295 (1983). https://doi.org/10.1007/BF02469509

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  • DOI: https://doi.org/10.1007/BF02469509

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