Document Detail


Surgical strategy for large or malignant endocrine pancreatic tumors.
MedLine Citation:
PMID:  11038206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Endocrine pancreatic tumors (EPTs) are rare but have a remarkably better prognosis than adenocarcinoma of the pancreas. Patients with EPTs benefit from surgical and medical therapy, which may alleviate symptoms due to hormonal excess and increase survival. Patients with large or malignant EPTs with infiltrative disease may suffer from local complications, including gastrointestinal bleeding and obstruction and involvement of the superior mesenteric (SMV) and portal (PV) veins. Among 31 patients with operable and large or malignant EPTs, 7 had hormone-producing syndromes (insulin, glucagon), and 24 had clinically nonfunctioning EPTs. Surgery in these patients included vascular reconstruction of the SMV/PV (n = 4), resection of infiltrated adjacent organs (n = 5; stomach, transverse colon), or resection of concomitant liver metastases (n = 3). Four patients with conspicuously large insulinomas, and three with glucagonoma were successfully operated on with alleviation of hormonal symptoms. Among the 24 nonfunctioning EPTs, 5 patients had been explored earlier and their tumors judged inoperable due to locally invasive disease or misdiagnosis as pancreatic adenocarcinoma. The operations were performed with no mortality and low morbidity. We conclude that large and malignant EPTs with limited spread of disease may benefit from a combination of medical and surgical therapy.
Authors:
P Hellman; M Andersson; J Rastad; C Juhlin; S Karacagil; B Eriksson; B Skogseid; G Akerström
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  24     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-21     Completed Date:  2000-12-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1353-60     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden. per.hellman@kirurgi.uu.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Biopsy, Needle
Carcinoma, Pancreatic Ductal / diagnosis*,  drug therapy,  mortality,  surgery*
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging
Pancreatectomy / adverse effects,  methods*
Pancreatic Neoplasms / diagnosis*,  drug therapy,  mortality,  surgery*
Retrospective Studies
Severity of Illness Index
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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