A lady presented with recurrent attacks of giddiness and abdominal pain since three months. Endoscopy was normal. Her fasting blood glucose was 40 mg % and insulin levels were elevated. CT abdomen showed a well defined 8 mm enhancing lesion in the head of pancreas, with no other abnormal findings. What should be the treatment plan for this patient?
Based on the clinical scenario, the patient is diagnosed to have insulinoma. Surgically solitary insulinomas is best managed by simple Enucleation. Enucleation means removing the tumor along with the pseudocapsule not just the resection. Whipples's procedure (pancreaticoduodenectomy) is a major surgical operation involving the pancreas, duodenum, and other organs. This procedure is usually done for the pancreatic head tumor. Ref: Pediatric Gastrointestinal Diseases By W. Allan Walker, Volume 2, Page 1207
Whipple's operation
Enucleation
Enucleation with radiotherapy
Administration of streptozotocin