Surgery for benign insulinoma: An international review

In a multiinstitutional review, data on 396 patients with benign solitary or multiple insullnomas operated on in 15 centers were collected. In these 396 patients, 419 laparotomies (375 primary procedures and 44 reoperafions) were performed. The rate of unnecessary laparotomies was 1.7%. Complications occurred after 132 operations (31.5%), requiring 27 reinterventions (6.4 %). Ten (2 %) patients died within 30 days of surgery. The succes s rate of first procedures in the centers ~vas 94.9%. After reoperation , all but 2 (99.5%) of these patients were cured. The overall cure rate including those patients who had their primary operations elsewhere was 97.5%. The results of surgical treatment of benign and malignant insulinomas are published as reports from single institutions [1-6] or as multiinstitutional reviews scanning the cases published within a certain period of time [7-10] or collecting cases in a country by questionnaires [11, 12]. Since the late 1970's when sophisticated and more reliable methods for diagnosis and localization of insulinomas became available, only a few institutions have published their data, usually based on a small series of patients [2-51, Fifteen years ago, stefanini and associates [10] published the last international review. Their data do not represent the results obtained today, e.g., a failure rate after primary operations of almost 25%, an operative mortality of 6.7% after primary and of 18% after reoperations. This article describes current representative figures of the outcome of management of these tumors in a large number of patients.