1NSULINOMA DIAGNOSTIC AND THERAPEUTIC EXPERIENCES IN 60 CASES

Experiences in the diagnosis and treatment of 60 cases of insulinoma are reported. Symptoms are analyzed. Blood sugar determination during an attack is most important for diagnosis. Using Whipple's triad as diagnostic criteria the accuracy of preoperative diagnosis was above 91c/o. The only effective treatment for insulinoma is surgical removal of the tumor. The possible causes for failure to find the tumor during ex- ploration are discussed. Simple enucleation is the preferred method of removal of insulinoma. When no tumor is found after thorough explora- tion, controlled staged resection of the pancreas from left to right under blood sugar monitoring is the procedure of choice. Postoperative com- plications are common, but the late results are gratifying provided the operation is carried out early in the course of the disease.