caa a22 4500 47580368X CHVBK 20180406123744.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010224 doi (NATIONALLICENCE)springer-10.1007/s002680010224 Surgical Strategy for Large or Malignant Endocrine Pancreatic Tumors [Elektronische Daten] [Per Hellman, Maria Andersson, Jonas Rastad, Claes Juhlin, Sadettin Karacagil, Barbro Eriksson, Britt Skogseid, Göran Åkerström] 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. Société Internationale de Chirurgie, 2000 Hellman Per Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Andersson Maria Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Rastad Jonas Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Juhlin Claes Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Karacagil Sadettin Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Eriksson Barbro Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Skogseid Britt Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Åkerström Göran Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1353-1360 0364-2313 24:11<1353 2000 24 268 https://doi.org/10.1007/s002680010224 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010224 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hellman Per Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Andersson Maria Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Rastad Jonas Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Juhlin Claes Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Karacagil Sadettin Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Eriksson Barbro Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Skogseid Britt Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Åkerström Göran Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1353-1360 0364-2313 24:11<1353 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer