Treatment, Prevention and Complications of Insulinoma

Updated: June 16, 2022

Insulinoma is a tumor of the pancreas that produces excessive amounts of insulin. The tumors are usually less than 2cm and most often these are are non-cancerous. These kind of tumors are more common in women. Insulinomas produce excessive amounts of insulin causing low blood sugar level or hypoglycemia.
When an insulinoma is formed in your pancreas, it will continue to produce insulin, even when your blood sugar is too low leading to hypoglycemia.

Treatment of Insulinoma:

Surgical removal of the tumor is the treatment of choice in most of the cases. There are various types of surgery that can be performed to remove the insulinoma. The type of surgery will be determined by the location and number of tumors. Most of patients will not require any further treatment after removal of the tumor. The type of surgery that are usually performed for removing the insulinoma include:

Enucleation:

In this procedure the surgeon removes only the tumor. The rest of the pancreas will be preserved with no serious effect of the surgery. Insulinomas can be completely removed without having to remove any of the surrounding pancreas as they usually occur on the surface of the pancreas and are covered by a capsule. The recurrence rate after enucleation of the insulinoma is very rare.

Pancreatic resection:

The surgeon may remove part of the pancreas where the tumor is located. This is the case if there are multiple insulinomas. Sometimes, part of the stomach or liver may be removed as well.

Laparoscopic operations:

Enucleation of the insulinoma is usually performed laparoscopically. Laparoscopic surgery is the preferred option if there is presence of only one small pancreatic tumor. This is a low-risk, minimally invasive procedure in which several small incisions in your abdomen are made and then a laparoscope is inserted through the incisions. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to see inside your abdomen and guide the instruments. Insulinoma will be removed When it is found.
The advantages of laparoscopic surgery are:

• the post-operative recovery period is less
• amount of pain is less compared to traditional surgery
• hospital stay is shorter and patients are able to return to their normal activity much faster.

When the tumors are cancerous only removing the insulinoma won't cure the condition. Cancerous insulinomas can be treated either by radiofrequency ablation, cryotherapy, chemotherapy or a combination of one of these with surgery.
Radiofrequency ablation uses radio waves to kill cancerous cells in the body. Cryotherapy involves the use of extreme cold to destroy cancerous cells and chemotherapy is an aggressive form of chemical drug therapy that helps destroy cancerous cells.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells, which is typically given as an infusion through a vein. The chemicals travel throughout your body and quickly kills the growing cells as well as the cancer cells.
Medications are prescribed to control blood sugar levels if surgery wasn't effective.

Complications of Insulinoma:

Most people recover completely without complications after a surgery. However, the following complications may arise in some cases:

• Recurrence is more common in people who have multiple tumors. An insulinoma may return in the future at any time in the same or different location.
• People may develop diabetes after surgery. This usually occurs when the entire pancreas or a large portion of the pancreas is removed resulting in reduced production of insulin.
• When the tumors have spread to other organs, removal of all the tumors are not possible. This is particularly true if the tumor is cancerous. More treatment and follow-up care will be necessary in this case.

Prevention of Insulinoma:

The exact reason for formation of insulinoma is unknown. So there is no known way to prevent them. However, you can reduce your risk of developing hypoglycemia by exercising regularly and maintaining a healthy diet. This diet should include large portion of fruits, vegetables, and lean protein. You can also keep your pancreas healthy by eating less red meat, avoiding junk food and quitting smoking if you smoke.