Abstract
<title>Abstract</title> <p>Introduction. Insulinoma is a rare functional pancreatic neuroendocrine tumour that typically presents as a solitary, benign, and sporadic lesion, although it can be associated with multiple endocrine neoplasia type 1. Clinical manifestations result from intermittent insulin secretion and recurrent hypoglycemic episodes, particularly during fasting or physical exertion. Whipple's triad remains the diagnostic standard, with neuroglycopenic symptoms such as confusion, loss of consciousness, seizures, behavioural disturbances, amnesia, asthenia, and weakness being the most severe. Surgical intervention offers the only potentially curative treatment, with the approach determined by tumour location and size. Enucleation is recommended for small tumours that do not involve the main pancreatic duct, whereas pancreatic resection is commonly performed in other cases. The Whipple procedure is reserved for larger tumours located in the pancreatic head or for cases where malignancy is suspected. Case presentation. We present the case of a 32-year-old man with a one-year history of asthenia who underwent Whipple surgery. This case underscores the importance of considering metabolic etiologies in young patients to facilitate timely treatment and effective management of complications. Conclusions. Early diagnosis of insulinoma is critical in young patients presenting with neuroglycopenic symptoms, as delayed identification and management can adversely impact prognosis. Biliary stenosis following pancreatoduodenectomy is a common complication. This complication occurs more frequently in individuals with preoperative small-diameter bile ducts and in male patients. Biliary stenosis after pancreatoduodenectomy can be managed effectively with less invasive procedures such as endoscopic retrograde cholangiopancreatography or cholangioplasty.</p>