Diagnosis and treatment of insulinoma:analysis of  22 case        YANG Jun-feng*，SHA Cong，TIAN Ming-guo, et al. *Department of General Suregery, Nantong Rich Hospital, Nantong 226010,China
Corresponding author：YANG Jun-feng，E-mail:richyjf@sina.com
Abstract    Objective    To explore the diagnosis and management of insulinoma. Methods    The clinical data of 22 cases of insulinoma treated in the past 15 years were analyzed retrospectively. Results    All 22 cases had the signs of whipple triad. The positive rate of preoperative BUS,CT,MRI and selective portal vein sampling as well as intraoperative BUS were respectively 15.8%(3/19),67.5%(10/16),71.4%(5/7),100%(2/2) and 85.7%(6/7). The operation methods included tumor enucleation in 13cases, distal pancreatic resection in 3 cases, distal pancreatic resection plus splenectomy in1 case, Whipple’s procedure in1 case, resection of pancreatic head with preservation of the duodenum in1 case and laparoscopic enucleation of the tumor under laparoscopy in 3 cases. All tumors were pathologically benign. Hypoglycemia disappeared after resection in all cases. Conclusion    Whipple’s triad combined with IRI/G ratio measurement are still the main qualitation diagnosis. Two stage spinal CT thin scanning is the main method for tumor location. Intraoperative BUS is the supplement to preoperative location diagnosis. Tumor resection is the effective therapeutic method. Laparoscopic tumor enucleation should be recommended.