Anaesthetic Management During Laparoscopic Resection Of A Functioning Beta Cell Tumour (An Insulinoma)

Abstract

Insulinoma is a predominantly benign and rare neuroendocrine tumour. It was first described by Harris et al. In 1923, he introduced the clinical possibility of spontaneous “hyperinsulinismâ€, in patients with blood sugars below 70mg/dl whose symptoms improved by feeding. The incidence of insulinoma is four per million persons each year, and insulinomas often present as a solitary pancreatic tumour. Although the large majority of insulinomas are sporadic, upto 10% may be associated with hereditary multiple endocrine neoplasia type 1. Clinically it is diagnosed by Whipples pathognomic triad of symptoms which includes: repeated attacks of hypoglycaemia, documented hypoglycaemia (plasma glucose levels <50mg/dl) and immediate relief of symptoms by glucose administration.