Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist
Insulinoma represents a benign, insulin-secreting neuroendocrine tumor of the beta cells of islets of Langerhans in the pancreas, which leads to frequent episodes of hypoglycemia. Surgery is the definite treatment. However, the perioperative treatment of patients with insulinoma is highly challengin...
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Institute of Oncology, Sremska Kamenica, Serbia
2025-01-01
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| Series: | Archive of Oncology |
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| Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/0354-7310/2025/0354-73102501039M.pdf |
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| author | Mihalek Nora Starčević Sanja Erdoes Gabor Radovanović Dragana |
| author_facet | Mihalek Nora Starčević Sanja Erdoes Gabor Radovanović Dragana |
| author_sort | Mihalek Nora |
| collection | DOAJ |
| description | Insulinoma represents a benign, insulin-secreting neuroendocrine tumor of the beta cells of islets of Langerhans in the pancreas, which leads to frequent episodes of hypoglycemia. Surgery is the definite treatment. However, the perioperative treatment of patients with insulinoma is highly challenging. We present the perioperative management of a 46-year-old obese male patient with insulinoma. As the patient reported frequent severe hypoglycemia episodes, the main priority of the perioperative treatment was to prevent hypoglycemia before tumor resection and to control rebound hyperglycemia after tumor removal. Maintaining normoglycemia was challenging during the regular fasting period before abdominal surgery, as well as during the intervention, as general anaesthesia masks the symptoms of hypoglycemia. Obesity further complicated the anaesthetic management, due to expected difficult airway management and central venous access. Glycemia was monitored in 15-minute intervals during surgery and in 30-minute intervals postoperatively, and dysglycemia was corrected according to the trend of variations. As insulinoma is a rare phenomenon with an unpredictable clinical course, current reportings regarding the anaesthetic management of patients with this pathology are relatively lacking. Therefore, our case report could contribute to expanding the limited data about the perioperative treatment of patients with this condition. |
| format | Article |
| id | doaj-art-19d0f71805de48dc83ed0853f7d937f4 |
| institution | DOAJ |
| issn | 0354-7310 1450-9520 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Institute of Oncology, Sremska Kamenica, Serbia |
| record_format | Article |
| series | Archive of Oncology |
| spelling | doaj-art-19d0f71805de48dc83ed0853f7d937f42025-08-20T02:58:19ZengInstitute of Oncology, Sremska Kamenica, SerbiaArchive of Oncology0354-73101450-95202025-01-01311394210.2298/AOO250202002M0354-73102501039MPerioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologistMihalek Nora0https://orcid.org/0000-0003-0819-1932Starčević Sanja1Erdoes Gabor2Radovanović Dragana3https://orcid.org/0000-0002-5071-7929Oncology Institute of Vojvodina, Department for Anesthesiology with Reanimatology, Sremska Kamenica, SerbiaOncology Institute of Vojvodina, Department for Anesthesiology with Reanimatology, Sremska Kamenica, SerbiaUniversity of Bern, Inselspital, University Hospital Bern, Department of Anaesthesiology and Pain Medicine, Bern, SwitzerlandOncology Institute of Vojvodina, Department for Anesthesiology with Reanimatology, Sremska Kamenica, SerbiaInsulinoma represents a benign, insulin-secreting neuroendocrine tumor of the beta cells of islets of Langerhans in the pancreas, which leads to frequent episodes of hypoglycemia. Surgery is the definite treatment. However, the perioperative treatment of patients with insulinoma is highly challenging. We present the perioperative management of a 46-year-old obese male patient with insulinoma. As the patient reported frequent severe hypoglycemia episodes, the main priority of the perioperative treatment was to prevent hypoglycemia before tumor resection and to control rebound hyperglycemia after tumor removal. Maintaining normoglycemia was challenging during the regular fasting period before abdominal surgery, as well as during the intervention, as general anaesthesia masks the symptoms of hypoglycemia. Obesity further complicated the anaesthetic management, due to expected difficult airway management and central venous access. Glycemia was monitored in 15-minute intervals during surgery and in 30-minute intervals postoperatively, and dysglycemia was corrected according to the trend of variations. As insulinoma is a rare phenomenon with an unpredictable clinical course, current reportings regarding the anaesthetic management of patients with this pathology are relatively lacking. Therefore, our case report could contribute to expanding the limited data about the perioperative treatment of patients with this condition.https://scindeks-clanci.ceon.rs/data/pdf/0354-7310/2025/0354-73102501039M.pdfinsulinomaglycemiaanaesthetic managementcase report |
| spellingShingle | Mihalek Nora Starčević Sanja Erdoes Gabor Radovanović Dragana Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist Archive of Oncology insulinoma glycemia anaesthetic management case report |
| title | Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist |
| title_full | Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist |
| title_fullStr | Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist |
| title_full_unstemmed | Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist |
| title_short | Perioperative glycemia regulation for insulinoma surgery: Challenges faced by the anaesthesiologist |
| title_sort | perioperative glycemia regulation for insulinoma surgery challenges faced by the anaesthesiologist |
| topic | insulinoma glycemia anaesthetic management case report |
| url | https://scindeks-clanci.ceon.rs/data/pdf/0354-7310/2025/0354-73102501039M.pdf |
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