General Surgery · Endocrine
Pancreatic Endocrine Tumour Enucleation
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].