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Islet autotransplantation after left pancreatectomy for non-enucleable insulinoma

Mathe, Zoltan
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Published in American journal of transplantation. 2003, vol. 3, no. 10, p. 1302-7
Abstract Insulinoma is a rare, almost always benign endocrine tumor of the pancreas, clinically characterized by hyperinsulinemic, hypoglycemic episodes. Surgical excision is the therapy of choice, which may lead to postpancreatectomy diabetes mellitus in the case of extensive pancreatic resection. We present the cases and the metabolic follow up of two patients, 81 and 73 years old, with insulinoma localized close to the main duct in the pancreatic neck. Both patients underwent an 80% left pancreatectomy, avoiding a pancreatico-enteric anastomosis. In order to prevent postpancreatectomy diabetes, the islets from the tumor-free part of the resected pancreas were isolated and injected via a right colic vein into the portal system. After a follow up of 6 and 3 years respectively, both patients remained insulin-independent without any dietary restrictions. Fasting and glucagon-stimulated C-peptide-levels and glycosylated hemoglobin remained within normal range. There were no signs of recurrent insulinoma. Liver biopsy performed in one patient at 1 year after autotransplantation, showed intact, insulin-producing islets within the portal spaces. In conclusion, autologous islet transplantation can preserve the insulin secretory reserve after extended left pancreatectomy for the treatment of benign tumors in the pancreatic neck.
Keywords AgedAged, 80 and overBiopsyC-Peptide/bloodDiabetes Mellitus/etiology/therapyFemaleFollow-Up StudiesGlucose Tolerance TestGlycosylationHemoglobins/biosynthesisHumansInsulinoma/surgery/therapyIslets of Langerhans Transplantation/methodsLiver/pathologyMalePancreatectomy/adverse effects/methodsTime FactorsTransplantation, Autologous
PMID: 14510705
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Article (Published version) (229 Kb) - public document Free access
Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Diabète et régulation des gènes (36)
Hépatologie chirurgicale (327)
(ISO format)
OBERHOLZER, José et al. Islet autotransplantation after left pancreatectomy for non-enucleable insulinoma. In: American journal of transplantation, 2003, vol. 3, n° 10, p. 1302-7. doi: 10.1046/j.1600-6143.2003.00218.x https://archive-ouverte.unige.ch/unige:37168

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Deposited on : 2014-06-04

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