pancreatic

2. PANCREATIC ISLET TUMORS
 The pancreas contains the islets (islands) of Langerhans, small nests of
cells that secrete directly into the bloodstream and therefore are part of
the endocrine system.
 The hormone insulin is essential for the metabolism of glucose.
 Diabetes mellitus is the result of deficient secretion of insulin.

3.  At least two types of tumors of the pancreatic islet cells are known:
those that secrete insulin (insulinoma) and those in which insulin
secretion is not increased (“nonfunctioning” islet cell cancer).
 Insulinomas produce hypersecretion of insulin and cause an excessive
rate of glucose metabolism.
 The resulting hypoglycemia may produce symptoms of weakness,
mental confusion, and seizures.

4.  These symptoms may be relieved almost immediately by oral or
intravenous administration of glucose.
 The 5-hour glucose tolerance test is helpful in diagnosing insulinoma
and in distinguishing it from other causes of hypoglycemia.

5. Surgical Management
 When a tumor of the islet cells has been diagnosed, surgical treatment
with removal of the tumor usually is recommended.
 The tumors may be benign adenomas or they may be malignant.
 Complete removal usually results in almost immediate relief of
symptoms.
 In some patients, symptoms may be produced by simple hypertrophy
of this tissue rather than a tumor of the islet cells.
 In such cases, a partial pancreatectomy (removal of the tail and part of
the body of the pancreas) is performed.

6. Nursing Management
 In preparing the patient for surgery, the nurse must be alert for
symptoms of hypoglycemia and be ready to administer glucose as
prescribed if symptoms occur.
 Postoperatively, the nursing management is the same as that after
other upper abdominal surgical procedures, with special emphasis on
monitoring serum glucose levels.
 Patient teaching is determined by the extent of surgery and the
alterations in pancreatic function that result.
 Thanking you.