Minimally invasive versus open surgery for insulinoma: a 20-year institutional experience

IF 3.3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2026-09-01 Epub Date: 2026-06-11 DOI:10.1016/j.hpb.2026.06.002

Sagar D. Patel, Ranim Alsaad, John L. Cameron, Christopher R. Shubert, Richard A. Burkhart, William R. Burns, Jin He, Kelly J. Lafaro

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引用次数: 0

Abstract

Background

There is a growing trend towards using a minimally invasive approach (MIS) for patients with insulinoma. We aim to compare the perioperative and oncologic outcomes of open approach versus MIS over a 20-year period.

Methods

We conducted a retrospective single institution cohort study of patients who underwent surgical resection for insulinoma between 2004 and 2024. Patients were grouped by surgical approach: open or MIS, and outcomes were analyzed.

Results

28 patients (37.8%) underwent an open approach, and 46 patients (62.2%) underwent an MIS approach. Parenchymal-preserving approach was more commonly done in the MIS group (54.3% vs. 28.6%, p = 0.009). Resection done by a MIS approach was associated with shorter length of stay (5.0 vs. 6.5 days, p = 0.011), fewer grade III/IV surgical complications (19.6% vs. 32.1%, p = 0.15), lower 30-day readmission rates (17.4% vs. 42.9%, p = 0.034), and no cases of incisional hernia (0% vs. 14.3%%, p = 0.018) within two years post-operatively. The difference in local recurrence rates was not statistically significant (4.3% vs. 3.6%, p = 1).

Discussion

Our experience highlights that an MIS approach allows for greater use of parenchymal-sparing techniques and improved short-term outcomes while maintaining oncologic integrity.

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微创与开放手术治疗胰岛素瘤：20年的机构经验。

背景：胰岛素瘤患者采用微创入路（MIS）的趋势越来越明显。我们的目的是比较开放入路与MIS在20年的围手术期和肿瘤预后。方法：我们对2004年至2024年间接受胰岛素瘤手术切除的患者进行了回顾性单机构队列研究。患者按手术入路进行分组：开放或MIS，并分析结果。结果：开放入路28例（37.8%），MIS入路46例（62.2%）。MIS组更常采用保实质入路（54.3%比28.6%,p = 0.009）。MIS入路的切除与更短的住院时间（5.0 vs. 6.5天，p = 0.011），更少的III/IV级手术并发症（19.6% vs. 32.1%, p = 0.15），更低的30天再入院率（17.4% vs. 42.9%, p = 0.034）以及术后两年内无切口疝病例（0% vs. 14.3%%, p = 0.018）相关。两组局部复发率差异无统计学意义（4.3% vs. 3.6%, p = 1）。讨论：我们的经验强调，MIS方法允许更多地使用保留实质的技术，并在保持肿瘤完整性的同时改善短期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).