BACKGROUND: To determine the accuracy and safety of a modified intra-arterial @entity460 stimulation with the venous sampling test (ASVS) for preoperative @entity9608 . Modification included stimulation with a fixed low dose of @entity10041 , additional stimulation in the distal splenic artery, and no @entity2690 sampling in the left hepatic vein. METHODS: In 10 @entity1 showing biochemical evidence of @entity347 , 0.45 mmol of @entity141 was injected into the gastroduodenal, superior mesenteric, proper hepatic, proximal, and distal splenic arteries during angiography. @entity2690 levels were measured in samples taken from the right hepatic vein before and 30, 60, 90, 120, 180, and 300 s after @entity141 injection. RESULTS: @entity2690 gradients with an increase of more than fourfold indicated direct @entity5 supply, two- to fourfold correlated with collateral supply, and less than twofold correlated with normal tissue vascularization. ASVS localized all the @entity652 of the pancreatic head (n = 3) and body (n = 2) and two of four @entity652 of the tail correctly, as confirmed by surgery. Two @entity652 of the proximal pancreatic tail were erroneously localized to the body segment, but the fault was rectified by angiography. In one @entity1 with a negative ASVS and without exploration, the diagnosis of an @entity9608 was revised. CONCLUSION: ASVS with a fixed low dose of @entity10041 is a highly accurate and safe method for preoperative @entity9608 . Sampling in the left hepatic vein can be routinely omitted. Additional stimulation in the distal splenic artery seems helpful in surgical decision making, but additional experience is needed.

Modified intra-arterial @entity460 stimulation with venous sampling test for preoperative XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity9608 :: ('MESH:D007340', 'Disease') :: ['localization of insulinomas', 'insulinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity2690 :: ('3630', 'Gene') :: ['Insulin', 'insulin'] @entity10041 :: ('MESH:D002125', 'Chemical') :: ['calcium gluconate'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity141 :: ('CHEBI:29108', 'Chemical') :: ['Ca2+'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas'] @entity347 :: ('MESH:D019965', 'Disease') :: ['organic hyperinsulinemia']
@entity9608 :: (MESH:D007340,Disease) :: ['localization of insulinomas']
