General Surgery · Endocrine

Pancreatic Endocrine Tumour Enucleation

OPERATION: Pancreatic Endocrine Tumour Enucleation
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: IV cephalosporin at induction. VTE prophylaxis.
POSITION: Supine. Midline or chevron incision. Intraoperative USS available.

INDICATION:
Benign pancreatic endocrine tumour — [insulinoma / somatostatinoma / VIPoma / glucagonoma / non-functioning islet cell tumour / serous cystadenoma]. Preoperative localisation: EUS, CT, MRI, [octreotide scintigraphy, selective venous sampling]. Tumour localised to [head / body / tail] of pancreas — remote from main pancreatic duct on imaging. No evidence of malignancy or metastatic disease confirmed. [Insulinoma: IV glucose commenced pre-operatively — blood glucose monitoring established].

PROCEDURE:
WHO Checklist performed.

ABDOMINAL EXPLORATION:
Midline or bilateral subcostal incision. Full laparotomy performed — liver, regional lymph nodes, and ovaries (females) assessed to exclude metastatic disease. [Enlarged lymph nodes — formal resection rather than enucleation if confirmed malignant].