Prophylactic Cholecystectomy in Midgut Carcinoid Patients

Abstract

In our study the incidence of gallstone-related complications seems to be higher than in the general population. We recommend that prophylactic cholecystectomy is liberally performed during laparotomy for MGC if patients are planned to undergo treatment with somatostatin analogs.

ENETS Consensus Guidelines Update for Neuroendocrine Neoplasms of the Jejunum and Ileum

“…However, prospective proof of this concept has never been produced, and there is an ongoing debate as to whether routine cholecystectomy is required or not [100,101] because the increased incidence of cholelithiasis does not consistently lead to cholecystitis. It may therefore be individually decided by the surgeon, depending on technical and clinical aspects (e.g.…”

Principles of diagnosis and management of neuroendocrine tumours

“…54 Additionally, patients treated with somatostatin analogues have an increased risk of cholelithiasis and biliary sludge development; therefore, prophylactic cholecystectomy should be considered for patients starting long-term treatment with somatostatin analogues. 7,8,55,56 However, this recommendation has never been evaluated in a prospective study and is based on retrospective studies that showed high rates of cholelithiasis (52%-63%) and modest rates of symptomatic gallbladder disease (7%-15%). 55,56 Surgery Surgery plays an important role even in the setting of metastatic disease.…”

“…7,8,55,56 However, this recommendation has never been evaluated in a prospective study and is based on retrospective studies that showed high rates of cholelithiasis (52%-63%) and modest rates of symptomatic gallbladder disease (7%-15%). 55,56 Surgery Surgery plays an important role even in the setting of metastatic disease. Resection of the primary, if located in the small bowel, is usually undertaken to prevent obstruction later, particularly for low-grade tumours with good prognosis.…”

Controversies in the treatment of digestive neuroendocrine tumors

“…In association with the intestinal resection, cholecystectomy should be performed in order to prevent gallstones due to long-term treatment with somatostatin analogue. [16] …”