FUNCTIONING BETA ISLET CELL TUMORS - PREOPERATIVE TESTS AND SURGICAL APPROACH

At the Peter Bent Brigham Hospital recent experience with islet cell tumors of the pancreas suggests that there is still a clinical need for clarification of preoperative tests and surgical approach. The importance of properly interpreted current diagnostic tests in the evaluation of patients with suspected insulin-secreting pancreatic tumors is emphasized. Serum glucose level after a prolonged fast, the intravenous tolbutamide test, and serum insulin assays are the most informative of these tests. When islet cell adenoma cannot be palpated at operation, and preoperative tests are strongly indicative of hyperinsulinism, it is suggested that the surgical strategy be that of progressive pancreatic resection from tail to head with concomitant intraoperative monitoring of the blood glucose level. © 1969.