{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:12:37Z","timestamp":1788865957837,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":250,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Insulinoma is the most common functional pancreatic neuroendocrine tumor, typically benign, solitary, and sporadic, with an estimated incidence of 1\u20134 cases per million per year worldwide. It causes recurrent hypoglycemia through inappropriate insulin secretion, classically presenting as Whipple\u2019s triad and confirmed by a prolonged supervised fasting test. Surgical enucleation remains the preferred treatment for small, well\u2010localized benign insulinomas, allowing maximal preservation of pancreatic parenchyma. We report two cases of sporadic pancreatic insulinoma managed by open enucleation at a tertiary referral center in Senegal, West Africa, where advanced diagnostic modalities such as endoscopic ultrasound (EUS), somatostatin receptor scintigraphy, and selective arterial secretagogue injection (SASI) testing were unavailable. The first case was a 30\u2010year\u2010old woman presenting with a severe hypoglycemic coma complicated by status epilepticus on postpartum day 10. Abdominal CT scan identified a pancreatic head lesion. Biochemical workup confirmed insulinoma with a fasting blood glucose of 0.30\u2009g\/L (30\u2009mg\/dL; 1.7 mmol\/L), elevated fasting insulin at 32.7 \u00b5U\/mL, and C\u2010peptide at 2.92\u2009ng\/mL. Open enucleation was performed; the postoperative course was complicated by a transient infectious syndrome managed with broad\u2010spectrum antibiotics. Histopathology confirmed a well\u2010differentiated Grade 1 neuroendocrine tumor. Complete resolution of hypoglycemic episodes was achieved with no recurrence at 1 year. The second case involved a 55\u2010year\u2010old man with a 12\u2010year history of recurrent neuroglycopenic episodes. CT scan revealed an isthmic pancreatic lesion. Enucleation was performed; the postoperative course was complicated by a high\u2010output pancreatic fistula (Grade B, ISGPS 2016 classification), managed conservatively with fasting, parenteral nutrition, and close radiological monitoring, without surgical reintervention. Histopathology confirmed a low\u2010grade neuroendocrine tumor. No recurrence of hypoglycemia was observed at 5 months. These cases demonstrate that open enucleation is a feasible, effective, and parenchyma\u2010sparing option for benign sporadic insulinomas, even in resource\u2010limited settings where advanced localization and intraoperative techniques remain unavailable.<\/jats:p>","DOI":"10.1155\/cris\/3856631","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:58:51Z","timestamp":1788865131000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Management of Sporadic Pancreatic Insulinomas in a Resource\u2010Limited Setting: A Report of Two Cases"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3143-875X","authenticated-orcid":false,"given":"Yacine","family":"Seye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5859-7642","authenticated-orcid":false,"given":"Mouhamadou Laye","family":"Diop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamadou Lamine","family":"Gueye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinabou","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Seck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2737-9466","authenticated-orcid":false,"given":"Madieng","family":"Dieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn351"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)62083-7"},{"key":"e_1_2_12_3_2","first-page":"783","article-title":"Insulin Secretion and Insulin-Producing Tumors","volume":"35","author":"Guettier J. M.","year":"2006","journal-title":"Expert Review of Endocrinology & Metabolism"},{"key":"e_1_2_12_4_2","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1056\/NEJM199504273321707","article-title":"Hypoglycemic Disorders","volume":"332","author":"Service F. J.","year":"1995","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_12_5_2","first-page":"559","article-title":"Endoscopic Ultrasound in the Diagnosis of Endocrine Tumours of the Pancreas","volume":"34","author":"Rickes S.","year":"2002","journal-title":"Endoscopy"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1163176"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.115.157768"},{"key":"e_1_2_12_8_2","first-page":"539","article-title":"Surgical Management of Insulinoma: Outcomes After Enucleation and Pancreatic Resection","volume":"391","author":"Mehrabi A.","year":"2006","journal-title":"Langenbecks Arch Surg"},{"key":"e_1_2_12_9_2","first-page":"831","article-title":"Laparoscopic Versus Open Enucleation for Pancreatic Insulinoma: A Multicenter Case-Matched Study","volume":"262","author":"Jilesen A. P.","year":"2015","journal-title":"Annals of Surgery"},{"key":"e_1_2_12_10_2","first-page":"1059","article-title":"Surgical Management of Sporadic Insulinoma: Preoperative Localization and Intraoperative Strategy","volume":"254","author":"Gaujoux S.","year":"2011","journal-title":"Annals of Surgery"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000335587"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-023-01415-1"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3924"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000335591"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-3445"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5280"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-024-02472-6"},{"key":"e_1_2_12_18_2","first-page":"509","article-title":"Preoperative Localization and Intraoperative Glucose Monitoring in the Management of Patients With Pancreatic Insulinoma","volume":"163","author":"Katz L. B.","year":"1986","journal-title":"Surgery Gynecology & Obstetrics"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_12_20_2","first-page":"1225","article-title":"Long-Term Outcomes of Surgical Management of Insulinomas: A Systematic Review and Meta-Analysis","volume":"161","author":"Wang Y.","year":"2017","journal-title":"Surgery"}],"container-title":["Case Reports in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/3856631","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cris\/3856631","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cris\/3856631","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:58:53Z","timestamp":1788865133000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cris\/3856631"}},"subtitle":[],"editor":[{"given":"Semonti","family":"Nandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cris\/3856631"],"URL":"https:\/\/doi.org\/10.1155\/cris\/3856631","archive":["Portico"],"relation":{},"ISSN":["2090-6900","2090-6919"],"issn-type":[{"value":"2090-6900","type":"print"},{"value":"2090-6919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3856631"}}