Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 11 P525

ECE2006 Poster Presentations Endocrine tumours and neoplasia (116 abstracts)

Investigation and surgical management of pancreatic neuroendocrine tumours

FM Coyle 1 , WM Drake 1 , SL Chew 1 , P Jenkins 1 , RR Hutchins 2 , AB Grossman 1 , JP Monson 1 & S Bhattacharya 2

1Department of Endocrinology, London, United Kingdom; 2Department of Surgery, Barts and the London NHS Trust, London, United Kingdom.

Introduction: Diagnosis of pancreatic neuroendocrine tumours (NETs) is often a challenge and involves biochemical characterisation and anatomic localisation of the tumour. Wherever feasible, curative surgical excision is the treatment of choice.

Materials and Methods: Twenty four consecutive patients with pancreatic NETs were referred for consideration of surgery over a six-year period (1999–2005). Following use of multi imaging modalities to localise, all were operated on by the same surgical team.

Results: Twenty-four patients underwent surgical resection (11 women, 13 men; age 21–77 years, median 53). Sixteen tumours secreted known hormones (11 insulinomas, 1 somatostatinoma, 1 gastrinoma, 1 glucagonoma, and 2 multiple islet cell tumours) and 8 were non-functioning. Three tumours were part of the MEN 1 Syndrome. All 24 tumours were successfully localised prior to resection. Operations performed included 7 pylorus preserving pancreatoduodenectomies, 7 tumour enucleations, 7 distal pancreatectomies, 1 duodenum-preserving resection of pancreatic head, 1 excision of retropancreatic gastrinoma, and 1 liver segment resection were performed. There were no fatalities. Six patients (25%) had perioperative complications. These included wound infection (2), pancreatic leak managed conservatively with drainage and octreotide (2), and peri-pancreatic collection requiring percutaneous drainage (2). One late complication involved a duodenal stricture after a duodenum-preserving resection of the pancreatic head. Complete excision with symptomatic cure was documented in 20 patients. Of the remaining 4, two had MEN 1 with multiple islet cell tumours. One patient with neuroendocrine carcinoma (positive resection margins) received adjuvant chemotherapy. One patient had MIBG avid liver metastases and received targeted radiotherapy for these.

Conclusion: Accurate pre-operative localisation can be achieved in pancreatic NETs and facilitates pancreas sparing surgery. Surgical resection can be performed in high-volume centres with a very low mortality and acceptable morbidity, and carries a high likelihood of cure.

Volume 11

8th European Congress of Endocrinology incorporating the British Endocrine Societies

European Society of Endocrinology 
British Endocrine Societies 

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