Neuroendocrine tumors of the gut

Durning, P; Galland, R. B.; Nagorney, David M.; Welbourn, Richard

doi:10.1007/bf01656332

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…Most cases of intractable peptic ulcération and all cases of hepatic métastases were confined to this subset of patients, who appear to be ap¬ propriate candidates for pancreatic surgery. 8. Neuroendocrine hyperplasia and sometimes microcarcinoids have been identified in the gastric or duode¬ nal mucosa at surgical resection or in endoscopie biopsy specimens from patients with MEN 1 who have never taken omeprazole.…”

Section: Mortality Due To Malignant Gastrinomamentioning

confidence: 99%

Multiple Endocrine Neoplasm, Type 1

Shepherd

Challis²,

Davies³

et al. 1993

Arch Surg

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Sixty-two patients had evidence of gastrinoma or pancreatic neoplasm. In 19 patients the diagnosis was based on demonstration of a tumor. In 21 patients the diagnosis was based on elevated serum gastrin concentration in the absence of demonstrable tumor. None of these patients required gastric surgery if they first underwent parathyroidectomy. In 18 patients the diagnosis was based on the combination of demonstrated pancreatic tumor plus elevated glucagon (two patients), gastrin (11 patients), or insulin (five patients) concentration. Peptic ulcer was difficult to control in seven of the 11 patients with elevated gastrin concentrations plus demonstrated tumor. Four patients had liver metastases that appeared to be secondary to the pancreatic gastrinoma. In patients with insulinomas, the first symptoms occurred before age 20 years. Elevated serum gastrin concentrations were not seen before age 24 years and were observed to occur for the first time in two patients after age 50 years.

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Section: Mortality Due To Malignant Gastrinomamentioning

confidence: 99%

Multiple Endocrine Neoplasm, Type 1

Shepherd

Challis²,

Davies³

et al. 1993

Arch Surg

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“…Three patients in this series had symptoms due to the production of more than one peptide. In all 3 endocrine manifestations occurred se quentially [6].…”

Section: Pancreatic Pathologymentioning

confidence: 99%

“…Localisation of the lesions was achieved by angiography, venous sampling, ultrasound and/or CT scanning. At Hammersmith Hospital angiography has proved to be the most reliable means of localising this type of lesion but CT scanning has yet to be fully evalu ated [6]. On removing the tumours, immunocytochemistry was performed in each case.…”

Section: Pre-operative Evaluationmentioning

confidence: 99%

Practical Aspects of Distal Pancreatectomy

Galland¹,

Halliday²,

Blumgart³

1986

Dig Surg

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From 1979 to 1984, 54 pancreatectomies have been performed, including 20 distal pancreatectomies. The primary pathology was tumour (benign insulinoma 3, malignant vipoma 3, mixed endocrine tumours 3, cystadenoma 1 and cystadenocarcinoma 1), pancreatitis (acute 5, chronic 2) and trauma (2). Tumours were reliably located pre-operatively by angiography, CT and ultrasound, and pancreatic cysts (3) were accurately defined with CT and ultrasound. Radiological visualisation of the pancreatic duct with ERCP or operative pancreatography demonstrated ductal strictures in 5 cases of pancreatitis. Since the tumours are often large (up to 12 cm in diameter) and invading the mesocolon, pre-operative bowel preparation is used routinely in the event colonic resection is required. Approaching these tumours from below the transverse mesocolon allows easier identification of the vasculature. We prefer to transect the normal pancreas with a GIA stapler but to oversew the pancreatic stump with silk if the pancreas is inflamed. Enteral drainage of the stump was performed in 3 cases. Four patients died (2 with tumour and 2 with pancreatitis), all of whom developed intra-abdominal sepsis postoperatively. Three other patients had lifethreatening complications (pancreatic and intra-abdominal abscess, faecal fistula and septicaemia). Risk factors predisposing to severe postoperative complications included pre-existing malnutrition (p = 0.025), infection (p = 0.014), inflammation of the gland (p = 0.016), or previous pancreaticobiliary operations (p = 0.003, Fisher’s exact test). Three other patients had short-lived pancreatic fistulae which closed spontaneously, and 1 became diabetic.

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Surgical Aspects of Carcinoid Tumours

Galland¹

1993

Surgical Endocrinology

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Neuroendocrine tumors of the gut

Cited by 5 publications

References 24 publications

Multiple Endocrine Neoplasm, Type 1

Multiple Endocrine Neoplasm, Type 1

Practical Aspects of Distal Pancreatectomy

Surgical Aspects of Carcinoid Tumours

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