Surgery to remove the tumour is the treatment of choice for insulinoma. The details of the procedure are described later, but the principles are:
Medical approaches are used to render the patient safe before, during and after the operation. Pre-operatively, this entails dietary advice to prevent hypoglycaemic attacks. The night before surgery, intravenous dextrose solution is given to maintain blood glucose levels during surgery. Then, during operation, the glucose levels are continuously checked, and glucose or insulin given appropriately to maintain normal levels. Post-operatively, a normal hyperglycaemia occurs (due to the removal of insulin that the body was getting used to) but this should resolve in under a week. This rarely requires further insulin therapy.
With an experienced surgeon, success rates are around 95%.