Glucagonoma surgery
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Glucagonoma Microchapters |
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Glucagonoma surgery On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Mohammed Abdelwahed M.D[3]
Overview
Surgery is the mainstay of treatment for glucagonoma. The feasibility of surgery depends on the stage of glucagonoma at diagnosis. Hepatic resection is indicated for the treatment of metastatic liver disease in patients who are candidates for surgery with no extensive extrahepatic metastases.
Surgery
Management of primary disease
- Surgery is the mainstay of treatment for glucagonoma.
- Resection of the primary pancreatic tumor is indicated if the tumor is resectable in good general condition patients. It offers the chance of complete cure.[1]
- Preoperative management: total parenteral nutrition may be required before the surgery. Infusions of amino and fatty acids reduce symptoms and improve survival rates.[2]
- The feasibility of surgery depends on the stage of glucagonoma at diagnosis.[3][4]
- Single, small lesion in head or tail of pancreas: Enucleation, if feasible
- Large lesion in the head of the pancreas that is not amenable to enucleation: Pancreaticoduodenectomy
- Single, large lesion in body/tail: distal pancreatectomy
- Multiple lesions: Enucleation, if feasible
Management of metastasis
Hepatic resection is indicated for the treatment of metastatic liver disease in patients who are candidates for surgery with no extensive extrahepatic metastases. It may potentially increase survival and has the benefit of symptom palliation.[5]
References
- ↑ Smith AP, Doolas A, Staren ED (1996). "Rapid resolution of necrolytic migratory erythema after glucagonoma resection". J Surg Oncol. 61 (4): 306–9. doi:10.1002/(SICI)1096-9098(199604)61:4<306::AID-JSO15>3.0.CO;2-3. PMID 8628004.
- ↑ Alexander EK, Robinson M, Staniec M, Dluhy RG (2002). "Peripheral amino acid and fatty acid infusion for the treatment of necrolytic migratory erythema in the glucagonoma syndrome". Clin Endocrinol (Oxf). 57 (6): 827–31. PMID 12460334.
- ↑ Zhang M, Xu X, Shen Y, Hu ZH, Wu LM, Zheng SS (2004). "Clinical experience in diagnosis and treatment of glucagonoma syndrome". Hepatobiliary Pancreat Dis Int. 3 (3): 473–5. PMID 15313692.
- ↑ Pancreatic Neuroendocrine Tumors (Islet Cell Tumors). National Cancer Institute. http://www.cancer.gov/types/pancreatic/hp/pnet-treatment-pdq#section/_88
- ↑ McEntee GP, Nagorney DM, Kvols LK, Moertel CG, Grant CS (1990). "Cytoreductive hepatic surgery for neuroendocrine tumors". Surgery. 108 (6): 1091–6. PMID 1701060.