A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas

Amelia C. Grover, Monica Skarulis, H. Richard Alexander, James F. Pingpank, Edward D. Javor, Richard Chang, Thomas Shawker, Phil Gorden, Craig Cochran, Steven K. Libutti, John A. Chabot, Jay K. Harness, Quan Yang Duh, Terry C. Lairmore, Henning Dralle

Research output: Contribution to journalArticle

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Abstract

Background. Preoperative imaging studies localize insulinomas in less than 50% of patients. Arteriography with calcium stimulation and venous sampling (ASVS) regionalizes greater than 90% of insulinomas but requires specialized expertise and an invasive procedure. This prospective study evaluated laparoscopic exploration with IOUS compared with the other localization procedures in patients with a sporadic insulinoma. Methods. Between March 2001 and October 2004, 14 patients (7 women and 7 men; mean age, 53) with an insulinoma were enrolled in an IRB-approved protocol. Computed tomography, magnetic resonance imaging, ultrasound scan, and arteriography with calcium stimulation and venous sampling were performed preoperatively. A surgeon, blinded to the results of the localizing studies, performed a laparoscopic exploration with intraoperative ultrasound (IOUS). At the completion of the exploration, the success of laparoscopy for localization was scored, and the tumor was resected. Results. Twelve of 14 tumors were localized successfully before laparoscopy (noninvasive, 7 of 14; invasive, 11 of 14). Conclusion. Laparoscopic IOUS localized successfully 12 of 14 tumors. All lesions were resected, and all patients were cured (median follow-up, 36 months). Laparoscopic IOUS identified 86% of tumors. The authors consider laparoscopic IOUS to be equivalent to ASVS in localizing insulinomas. Further study is therefore warranted to determine the role of laparoscopy with IOUS in the localization and treatment algorithm for patients with sporadic insulinoma.

Original languageEnglish (US)
Pages (from-to)1003-1008
Number of pages6
JournalSurgery
Volume138
Issue number6
DOIs
StatePublished - Dec 2005
Externally publishedYes

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Insulinoma
Laparoscopy
Angiography
Calcium
Neoplasms
Research Ethics Committees
Tomography
Magnetic Resonance Imaging
Prospective Studies

ASJC Scopus subject areas

  • Surgery

Cite this

Grover, A. C., Skarulis, M., Alexander, H. R., Pingpank, J. F., Javor, E. D., Chang, R., ... Dralle, H. (2005). A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas. Surgery, 138(6), 1003-1008. https://doi.org/10.1016/j.surg.2005.09.017

A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas. / Grover, Amelia C.; Skarulis, Monica; Alexander, H. Richard; Pingpank, James F.; Javor, Edward D.; Chang, Richard; Shawker, Thomas; Gorden, Phil; Cochran, Craig; Libutti, Steven K.; Chabot, John A.; Harness, Jay K.; Duh, Quan Yang; Lairmore, Terry C.; Dralle, Henning.

In: Surgery, Vol. 138, No. 6, 12.2005, p. 1003-1008.

Research output: Contribution to journalArticle

Grover, AC, Skarulis, M, Alexander, HR, Pingpank, JF, Javor, ED, Chang, R, Shawker, T, Gorden, P, Cochran, C, Libutti, SK, Chabot, JA, Harness, JK, Duh, QY, Lairmore, TC & Dralle, H 2005, 'A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas', Surgery, vol. 138, no. 6, pp. 1003-1008. https://doi.org/10.1016/j.surg.2005.09.017
Grover, Amelia C. ; Skarulis, Monica ; Alexander, H. Richard ; Pingpank, James F. ; Javor, Edward D. ; Chang, Richard ; Shawker, Thomas ; Gorden, Phil ; Cochran, Craig ; Libutti, Steven K. ; Chabot, John A. ; Harness, Jay K. ; Duh, Quan Yang ; Lairmore, Terry C. ; Dralle, Henning. / A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas. In: Surgery. 2005 ; Vol. 138, No. 6. pp. 1003-1008.
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abstract = "Background. Preoperative imaging studies localize insulinomas in less than 50{\%} of patients. Arteriography with calcium stimulation and venous sampling (ASVS) regionalizes greater than 90{\%} of insulinomas but requires specialized expertise and an invasive procedure. This prospective study evaluated laparoscopic exploration with IOUS compared with the other localization procedures in patients with a sporadic insulinoma. Methods. Between March 2001 and October 2004, 14 patients (7 women and 7 men; mean age, 53) with an insulinoma were enrolled in an IRB-approved protocol. Computed tomography, magnetic resonance imaging, ultrasound scan, and arteriography with calcium stimulation and venous sampling were performed preoperatively. A surgeon, blinded to the results of the localizing studies, performed a laparoscopic exploration with intraoperative ultrasound (IOUS). At the completion of the exploration, the success of laparoscopy for localization was scored, and the tumor was resected. Results. Twelve of 14 tumors were localized successfully before laparoscopy (noninvasive, 7 of 14; invasive, 11 of 14). Conclusion. Laparoscopic IOUS localized successfully 12 of 14 tumors. All lesions were resected, and all patients were cured (median follow-up, 36 months). Laparoscopic IOUS identified 86{\%} of tumors. The authors consider laparoscopic IOUS to be equivalent to ASVS in localizing insulinomas. Further study is therefore warranted to determine the role of laparoscopy with IOUS in the localization and treatment algorithm for patients with sporadic insulinoma.",
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T1 - A prospective evaluation of laparoscopic exploration with intraoperative ultrasound as a technique for localizing sporadic insulinomas

AU - Grover, Amelia C.

AU - Skarulis, Monica

AU - Alexander, H. Richard

AU - Pingpank, James F.

AU - Javor, Edward D.

AU - Chang, Richard

AU - Shawker, Thomas

AU - Gorden, Phil

AU - Cochran, Craig

AU - Libutti, Steven K.

AU - Chabot, John A.

AU - Harness, Jay K.

AU - Duh, Quan Yang

AU - Lairmore, Terry C.

AU - Dralle, Henning

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N2 - Background. Preoperative imaging studies localize insulinomas in less than 50% of patients. Arteriography with calcium stimulation and venous sampling (ASVS) regionalizes greater than 90% of insulinomas but requires specialized expertise and an invasive procedure. This prospective study evaluated laparoscopic exploration with IOUS compared with the other localization procedures in patients with a sporadic insulinoma. Methods. Between March 2001 and October 2004, 14 patients (7 women and 7 men; mean age, 53) with an insulinoma were enrolled in an IRB-approved protocol. Computed tomography, magnetic resonance imaging, ultrasound scan, and arteriography with calcium stimulation and venous sampling were performed preoperatively. A surgeon, blinded to the results of the localizing studies, performed a laparoscopic exploration with intraoperative ultrasound (IOUS). At the completion of the exploration, the success of laparoscopy for localization was scored, and the tumor was resected. Results. Twelve of 14 tumors were localized successfully before laparoscopy (noninvasive, 7 of 14; invasive, 11 of 14). Conclusion. Laparoscopic IOUS localized successfully 12 of 14 tumors. All lesions were resected, and all patients were cured (median follow-up, 36 months). Laparoscopic IOUS identified 86% of tumors. The authors consider laparoscopic IOUS to be equivalent to ASVS in localizing insulinomas. Further study is therefore warranted to determine the role of laparoscopy with IOUS in the localization and treatment algorithm for patients with sporadic insulinoma.

AB - Background. Preoperative imaging studies localize insulinomas in less than 50% of patients. Arteriography with calcium stimulation and venous sampling (ASVS) regionalizes greater than 90% of insulinomas but requires specialized expertise and an invasive procedure. This prospective study evaluated laparoscopic exploration with IOUS compared with the other localization procedures in patients with a sporadic insulinoma. Methods. Between March 2001 and October 2004, 14 patients (7 women and 7 men; mean age, 53) with an insulinoma were enrolled in an IRB-approved protocol. Computed tomography, magnetic resonance imaging, ultrasound scan, and arteriography with calcium stimulation and venous sampling were performed preoperatively. A surgeon, blinded to the results of the localizing studies, performed a laparoscopic exploration with intraoperative ultrasound (IOUS). At the completion of the exploration, the success of laparoscopy for localization was scored, and the tumor was resected. Results. Twelve of 14 tumors were localized successfully before laparoscopy (noninvasive, 7 of 14; invasive, 11 of 14). Conclusion. Laparoscopic IOUS localized successfully 12 of 14 tumors. All lesions were resected, and all patients were cured (median follow-up, 36 months). Laparoscopic IOUS identified 86% of tumors. The authors consider laparoscopic IOUS to be equivalent to ASVS in localizing insulinomas. Further study is therefore warranted to determine the role of laparoscopy with IOUS in the localization and treatment algorithm for patients with sporadic insulinoma.

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