Surgery for Gastrinoma

Cisco, Robin M.; Norton, Jeffrey A.

doi:10.1016/j.yasu.2007.05.010

Cited by 25 publications

(14 citation statements)

References 42 publications

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“…During and 3 months after surgery, patients need adequately high doses of PPIs to efficiently control the acid hypersecretion that persists even after removal of the primary tumor mainly by residual hypertrophy of gastric mucosa [46] . The dose of antisecretory drug is titrated to reduce the acid hypersecretion to ≤ 10 mEq/h, or to lower values in patients with previous acid-reducing surgery or severe reflux disease.…”

Section: Gastrinomamentioning

confidence: 99%

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

et al. 2017

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Neuroendocrine tumors of the small intestine are the most common causes of the carcinoid syndrome. Carcinoid heart disease occurs in more than half of the patients with the carcinoid syndrome. Patients with carcinoid heart disease who need to undergo surgery should also undergo preoperative evaluation by an expert cardiologist. Treatment with long-acting somatostatin analogs aims at controlling the excessive hormonal output and symptoms related to the carcinoid syndrome and at preventing a carcinoid crisis during interventions. Patients with a gastrinoma require pre- and postoperative treatment with high doses of proton pump inhibitors. Patients with a glucagonoma require somatostatin analog treatment and nutritional supplementation. Patients with a VIPoma also require somatostatin analog treatment and intravenous fluid and electrolyte therapy. Insulinoma patients generally require intravenous glucose infusion prior to operation. In patients with localized operable insulinoma, somatostatin analog infusion should only be considered after the effect of this therapy has been electively studied.

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Section: Gastrinomamentioning

confidence: 99%

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

et al. 2017

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“…Gastrinomas are predisposed to GI perforation and haemorrhage, which may complicate surgery. During surgery, patients need adequate protection with PPIs to efficiently control the acid hypersecretion (Cisco & Norton 2007). In the acute setting where oral medications may be contraindicated, intravenous 80 mg of pantoprazole given by 15 min infusion every 8 h controlled gastric acid hypersecretion in all ZES patients studied both acutely and up to 7 days (Lew et al 2000).…”

Section: Gastrinoma and The Zollinger-ellison Syndromementioning

confidence: 99%

Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours

Dimitriadis¹,

Weickert²,

Randeva³

et al. 2016

Endocrine-Related Cancer

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Although recent epidemiological evidence indicates that the prevalence of non-functioning gastroenteropancreatic (GEP) neuroendocrine tumours (NETs) is rising, a significant number of GEP-NETs still present with symptoms related to the secretion of biologically active substances leading to the development of distinct clinical syndromes. In the past, these syndromes were associated with substantial morbidity and mortality due to the lack of specific therapies; however, since the introduction of long-acting somatostatin analogues and medications such as proton pump inhibitors, their control has been greatly improved. As a result, nowadays, the main cause of morbidity and mortality in GEP-NETs is mostly directly related to tumour growth and the extent of metastatic disease. However, in some patients with functioning tumours and extensive disease, control of the secretory syndrome still remains problematic, necessitating the employment of several cytoreductive techniques, which may not always be sufficient. Recently, new agents directed against tumour growth, or exerting increased binding activity to receptors expressed in these tumours, or interfering with the synthetic pathway of some of the compounds secreted by these tumours, have been developed. Since there are no specific guidelines addressing the totality of the management of the secretory syndromes related to GEP-NETs, this review aims at critically analysing the medical management of previously recognised secretory syndromes; it also addresses areas of uncertainty, assesses the newer therapeutic developments and also addresses recently described but poorly characterised secretory syndromes related to GEP-NETs.

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“…The treatment of sporadic gastrinomas entails complete surgical resection of the tumor and dissection of the regional lymph nodes[125]–[127]. If the tumor is in the pancreas, enucleation is appropriate, if it is feasible.…”

Section: Specific Types Of Pancreatic Neuroendocrine Tumorsmentioning

confidence: 99%

Pancreatic neuroendocrine tumors: biology, diagnosis,and treatment

Ro¹,

Chai²,

Yu³

et al. 2013

Chin J Cancer

139

130

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Pancreatic neuroendocrine tumors (PNETs), a group of endocrine tumors arising in the pancreas, are among the most common neuroendocrine tumors. The genetic causes of familial and sporadic PNETs are somewhat understood, but their molecular pathogenesis remains unknown. Most PNETs are indolent but have malignant potential. The biological behavior of an individual PNET is unpredictable; higher tumor grade, lymph node and liver metastasis, and larger tumor size generally indicate a less favorable prognosis. Endocrine testing, imaging, and histological evidence are necessary to accurately diagnose PNETs. A 4-pronged aggressive treatment approach consisting of surgery, locoregional therapy, systemic therapy, and complication control has become popular in academic centers around the world. The optimal application of the multiple systemic therapeutic modalities is under development; efficacy, safety, availability, and cost should be considered when treating a specific patient. The clinical presentation, diagnosis, and treatment of specific types of PNETs and familial PNET syndromes, including the novel Mahvash disease, are summarized.

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Surgery for Gastrinoma

Cited by 25 publications

References 42 publications

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pre- and Perioperative Therapy in Patients with Neuroendocrine Tumors

Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours

Pancreatic neuroendocrine tumors: biology, diagnosis,and treatment

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