Arterial stimulation and venous sampling for glucagonomas of the pancreas

Hidetoshi Eguchi, Masahiro Tanemura, Shigeru Marubashi, Shogo Kobayashi, Hiroshi Wada, Kohei Okita, Hiromi Iwahashi, Akihisa Imagawa, Iichiro Shimomura, Keigo Osuga, Koji Umeshita, Kenichi Wakasa, Masaki Mori, Yuichiro Doki, Hiroaki Nagano

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background/Aims: Arterial stimulation and venous sampling (ASVS) is a catheter-based diagnostic technique used to identify the localization of an insulinoma or gastrinoma. The aim of this study was to clarify the clinical significance of ASVS for glucagonomas. Methodology: Eight patients with pancreatic hypervascular tumors and elevated serum glucagon levels in the peripheral blood were enrolled. Pancreatic angiography was performed and a bolus dose of calcium was injected into a suitable artery. Hepatic venous blood samples were then obtained to measure concentrations of glucagon and insulin. All patients underwent surgical resection, and the resected specimens were investigated immunohistochemically. Results: Compared to insulin, the glucagon levels stabilized after calcium stimulation in four patients, with a 1.2-fold increase or decrease. In the remaining four patients, there was a 1.6- to 5.8-fold increase in glucagon levels. The peak value of glucagon was observed at 90s or 120s which was slower than the insulin peak observed in patients with insulinoma. The patients with elevated glucagon levels during ASVS exhibited positive immunostaining of glucagon in resected specimens. Conclusions: Increase in glucagon after calcium stimulation was observed in patients with glucagonomas. ASVS for glucagonomas may be useful in determining the most suitable surgical procedure.

Original languageEnglish
Pages (from-to)276-279
Number of pages4
JournalHepato-gastroenterology
Volume59
Issue number113
DOIs
Publication statusPublished - Jan 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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