Insulinoma After Bariatric Surgery: Diagnostic Dilemma and Therapeutic Approaches

Obesity Surgery

Volumn 26, Issue 4, 2016, Pages 874-881

  Mulla, Christopher M ^a,b,c   Storino, Alessandra ^b,c   Yee, Eric U ^b,c   Lautz, David ^c,d   Sawnhey, Mandeep S ^b,c   Moser, A James ^b,c   Patti, Mary Elizabeth ^a,b,c  

^a JOSLIN DIABETES CENTER   (United States)

^b BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

Bariatric surgery; Gastric bypass; Hypoglycemia; Insulinoma; Minimally invasive surgery

Indexed keywords

BARIATRIC SURGERY; COMPUTER ASSISTED TOMOGRAPHY; CONSERVATIVE TREATMENT; DIFFERENTIAL DIAGNOSIS; ENDOSCOPIC ECHOGRAPHY; HISTOPATHOLOGY; HUMAN; HYPOGLYCEMIA; INSULINOMA; MINIMALLY INVASIVE SURGERY; PANCREATIC NEUROENDOCRINE TUMOR; PEROPERATIVE ECHOGRAPHY; POSTOPERATIVE COMPLICATION; POSTOPERATIVE PERIOD; PREOPERATIVE EVALUATION; PRIORITY JOURNAL; REVIEW; SCREENING; STOMACH BYPASS; SURGICAL APPROACH; SURGICAL TECHNIQUE; TREATMENT OUTCOME; TREATMENT RESPONSE; TUMOR LOCALIZATION; ADVERSE EFFECTS; COMPLICATION; MORBID OBESITY; PANCREATIC NEOPLASMS;

BARIATRIC SURGERY; HUMANS; HYPOGLYCEMIA; INSULINOMA; OBESITY, MORBID; PANCREATIC NEOPLASMS; POSTOPERATIVE PERIOD;

EID: 84957542425     PISSN: 09608923     EISSN: 17080428     Source Type: Journal    
DOI: 10.1007/s11695-016-2092-5     Document Type: Review

References (49)

1. Patti ME, Goldfine AB. Hypoglycemia after gastric bypass: the dark side of GLP-1. Gastroenterology. 2014;146(3):605–8.
2. Papamargaritis D et al. Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(10):1600–6.
3. Calabria AC et al. Postoperative surveillance and detection of postprandial hypoglycemia after fundoplasty in children. J Pediatr. 2011;159(4):597–601. e1.
4. Goldfine AB et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin secretory responses to a mixed meal. J Clin Endocrinol Metab. 2007;92(12):4678–85.
5. Salehi M, Prigeon RL, D’Alessio DA. Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes. 2011;60(9):2308–14.
6. Jorgensen NB et al. Exaggerated glucagon-like peptide 1 response is important for improved beta-cell function and glucose tolerance after Roux-en-Y gastric bypass in patients with type 2 diabetes. Diabetes. 2013;62(9):3044–52.
7. Patti ME, Li P, Goldfine AB. Insulin response to oral stimuli and glucose effectiveness increased in neuroglycopenia following gastric bypass. Obesity (Silver Spring). 2015;23(4):798–807.
8. Patti, M.E., et al., Serum bile acids are higher in humans with prior gastric bypass: potential contribution to improved glucose and lipid metabolism. Obesity (Silver.Spring.), 2009.
9. Laferrere B et al. Differential metabolic impact of gastric bypass surgery versus dietary intervention in obese diabetic subjects despite identical weight loss. Sci Transl Med. 2011;3(80):80re2.
10. Hansen CF et al. Hypertrophy dependent doubling of L-cells in Roux-en-Y gastric bypass operated rats. PLoS ONE. 2013;8(6):e65696.
11. Liou AP et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med. 2013;5(178):178ra41.
12. Korner J et al. Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass. Int J Obes (Lond). 2009;33(7):786–95.
13. Abood GJ et al. Robotic-assisted minimally invasive central pancreatectomy: technique and outcomes. J Gastrointest Surg. 2013;17(5):1002–8.
14. Meier JJ et al. Hyperinsulinemic hypoglycemia after gastric bypass surgery is not accompanied by islet hyperplasia or increased {beta}-cell turnover. Diabetes Care. 2006;29(7):1554–9.
15. Placzkowski KA et al. Secular trends in the presentation and management of functioning insulinoma at the Mayo Clinic, 1987–2007. J Clin Endocrinol Metab. 2009;94(4):1069–73.
16. Birkmeyer NJ, Gu N. Race, socioeconomic status, and the use of bariatric surgery in Michigan. Obes Surg. 2012;22(2):259–65.
17. Cryer PE et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94(3):709–28.
18. Iglesias P et al. Insulinoma-induced hypoglycemia in a patient with nesidiodysplasia after vagomotomy and pyloroplasty for duodenal ulcer. Am J Med Sci. 2009;337(5):377–80.
19. Seshadri P et al. Rare case of insulinoma diagnosed after laparoscopic gastric banding. Surg Obes Relat Dis. 2009;5(1):123–7.
20. Edis AJ et al. Insulinoma—current diagnosis and surgical management. Curr Probl Surg. 1976;13(10):1–45.
21. Karmali S et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.
22. Saeidi N et al. Reprogramming of intestinal glucose metabolism and glycemic control in rats after gastric bypass. Science. 2013;341(6144):406–10.
23. Drucker DJ et al. Induction of intestinal epithelial proliferation by glucagon-like peptide 2. Proc Natl Acad Sci U S A. 1996;93(15):7911–6.
24. Goh BK et al. Accurate preoperative localization of insulinomas avoids the need for blind resection and reoperation: analysis of a single institution experience with 17 surgically treated tumors over 19 years. J Gastrointest Surg. 2009;13(6):1071–7.
25. Nikfarjam M et al. Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital. Ann Surg. 2008;247(1):165–72.
26. Gouya H et al. CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas. AJR Am J Roentgenol. 2003;181(4):987–92.
27. Vaidakis D et al. Pancreatic insulinoma: current issues and trends. Hepatobiliary Pancreat Dis Int. 2010;9(3):234–41.
28. Liu Y et al. The value of multidetector-row CT in the preoperative detection of pancreatic insulinomas. Radiol Med. 2009;114(8):1232–8.
29. McAuley G et al. Multimodality preoperative imaging of pancreatic insulinomas. Clin Radiol. 2005;60(10):1039–50.
30. Hirshberg B et al. Blind distal pancreatectomy for occult insulinoma, an inadvisable procedure. J Am Coll Surg. 2002;194(6):761–4.
31. Wilson JA et al. EUS in patients with surgically altered upper GI anatomy. Gastrointest Endosc. 2010;72(5):947–53.
32. Saftoiu A, Dietrich CF, Vilmann P. Contrast-enhanced harmonic endoscopic ultrasound. Endoscopy. 2012;44(6):612–7.
33. Hu M et al. Laparoscopic versus open treatment for benign pancreatic insulinomas: an analysis of 89 cases. Surg Endosc. 2011;25(12):3831–7.
34. Daouadi M et al. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 2013;257(1):128–32.
35. Antonakis PT, Ashrafian H, Martinez-Isla A. Pancreatic insulinomas: laparoscopic management. World J Gastrointest Endosc. 2015;7(16):1197–207.
36. Newman NA et al. Preoperative endoscopic tattooing of pancreatic body and tail lesions decreases operative time for laparoscopic distal pancreatectomy. Surgery. 2010;148(2):371–7.
37. Ayav A et al. Laparoscopic approach for solitary insulinoma: a multicentre study. Langenbecks Arch Surg. 2005;390(2):134–40.
38. Roslin MS et al. Response to glucose tolerance testing and solid high carbohydrate challenge: comparison between Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and duodenal switch. Surg Endosc. 2014;28(1):91–9.
39. Xu G et al. Exendin-4 stimulates both beta-cell replication and neogenesis, resulting in increased beta-cell mass and improved glucose tolerance in diabetic rats. Diabetes. 1999;48(12):2270–6.
40. Reubi JC et al. Glucagon-like peptide-1 (GLP-1) receptors are not overexpressed in pancreatic islets from patients with severe hyperinsulinaemic hypoglycaemia following gastric bypass. Diabetologia. 2010;53(12):2641–5.
41. Service FJ et al. Functioning insulinoma—incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66(7):711–9.
42. Ponce J et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011–2014. Surg Obes Relat Dis. 2015;11(6):1199–200.
43. Zagury L et al. Insulinoma misdiagnosed as dumping syndrome after bariatric surgery. Obes Surg. 2004;14(1):120–3.
44. Service GJ et al. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery. N Engl J Med. 2005;353(3):249–54.
45. Abellan P et al. Severe hypoglycemia after gastric bypass surgery for morbid obesity. Diabetes Res Clin Pract. 2008;79(1):e7–9.
46. Sato T et al. A case of insulinoma following total gastrectomy—effects of an alpha-glucosidase inhibitor on suppressing GIP and GLP-1 elevations. Diabetes Res Clin Pract. 2010;88(1):e4–6.
47. Guimaraes M et al. GLP1 and glucagon co-secreting pancreatic neuroendocrine tumor presenting as hypoglycemia after gastric bypass. Endocrinol Diabetes Metab Case Rep. 2015;2015:150049.
48. Koca YS et al. Insulinoma-induced hypoglycemia in a patient with insulinoma after gastrojejunostomy for prepyloric ulcer. Case Rep Surg. 2015;2015:127914.
49. Otonkoski T et al. Physical exercise-induced hyperinsulinemic hypoglycemia is an autosomal-dominant trait characterized by abnormal pyruvate-induced insulin release. Diabetes. 2003;52(1):199–204.