Ultrasonography was performed during 3 operations for pancreatic insulinomas. One patient was diagnosed as MEA type 1 and had two insulinomas. By intraoperative ultrasonography, all of four tumors were demonstrated as hypoechoic lesions compared to surrounding normal pancreas. Tumors were 10mm, 10mm, 13mm and 25mm in diameter. Majority of insulinomas are benign lesion. Enucleation is a preferable form of therapy for insulinomas with a low operative risk. In our series all tumors were excised by enucleation, including tumor located deep in the head of the pancreas. All patients cured by this procedure. Intraoperative ultrasonography is a safe and simple technique and can reduce blind resection of the pancreas.
Ultrasonography during operation for insulinoma was considered useful in the precise localizaiton, in excluding multiple lesions and moreover in performing the safe enucleation without pancreatic duct injury.