Surgery: How is preop localization of insulinoma?

Question

How is preop localization of insulinoma?

H K · Accepted Answer

ceCT : arterial Phase
EUS = Diagnostic modality of choice (sens 70-90%)
Laparoscopy with LUS
Transhepatic Portal venous sampling 
Selective arterial stimulation with Hepatic venous sampling (ASVS)
Stimulant  : Calcium (for insulinoma)  ,  Secretin (for gastrinoma)
Intraoperative palpate with IOUS

Surgery

How is preop localization of insulinoma?

CeCT : arterial Phase EUS = Diagnostic modality of choice (sens 70-90%) Laparoscopy with LUS Transhepatic Portal venous sampling Selective arterial stimulation with Hepatic venous sampling (ASVS) Stimulant : Calcium (for insulinoma) , Secretin (for gastrinoma) Intraoperative palpate with IOUS

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