Hi,
Thanks for writing in.
It is important to know if you have a functioning
insulinoma or non functioning tumor. Surgery for insulinoma requires complete preoperative work up and the surgery needs to be precise and specific. Locating the insulinoma requires both non invasive and invasive methods.
If operation is not done then following treatment might be recommended. Medical management of insulinoma is generally restricted to high-risk candidates for surgery, those not suitable for resection or in those who have undergone an unsuccessful operation with persistent symptoms. Options include dietary management,
diazoxide, calcium channel blockers and somatostatin analogues. Patients are advised to avoid prolonged fasting and to take frequent meals and snacks, including complex carbohydrates.
Tumor localization procedures are characterized as noninvasive in the case of transabdominal ultrasound (US) and triple-phase spiral computed
tomography (CT) of the pancreas and, in a few cases,
magnetic resonance imaging (MRI). Invasive localization/ regionalization procedures like EUS (
endoscopic ultrasound) and SACST (selective arterial calcium stimulation test) are used. With these techniques surgery has gained importance in the treatment of insulinomas. Please do not worry.