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Endocrine tumors of the pancreas.

Abstract

Pancreatic endocrine tumors are rare, yet can cause significant morbidity due to excessive secretion of hormones. Octreotide is effective in reducing the plasma concentrations of many of these hormones. The availability of potent H2-receptor antagonists and omeprazole has altered the emphasis in patients with Zollinger-Ellison syndrome away from total gastrectomy and towards resection of the gastrinoma for potential cure. Fifty percent of insulinomas and gastrinomas are not evident on preoperative imaging studies, despite their sophistication. Calcium angiography, endoscopic ultrasonography, isotope-labeled octreotide scanning, and injection of methylene blue during secretin angiography are recent imaging modalities that have shown promise in the localization of these tumors. Intraoperative ultrasound has emerged as the best method for operative detection of insulinomas. Duodenotomy and intraoperative endoscopic transillumination are especially important in the surgical management of Zollinger-Ellison syndrome because 30% to 40% of gastrinomas are located in the duodenum. The management of patients with multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome continues to be controversial. Some advocate an aggressive surgical approach, whereas others have had little success in rendering patients eugastrinemic.

Authors+Show Affiliations

Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7583963

Citation

Meko, J B., and J A. Norton. "Endocrine Tumors of the Pancreas." Current Opinion in General Surgery, 1994, pp. 186-94.
Meko JB, Norton JA. Endocrine tumors of the pancreas. Curr Opin Gen Surg. 1994.
Meko, J. B., & Norton, J. A. (1994). Endocrine tumors of the pancreas. Current Opinion in General Surgery, 186-94.
Meko JB, Norton JA. Endocrine Tumors of the Pancreas. Curr Opin Gen Surg. 1994;186-94. PubMed PMID: 7583963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endocrine tumors of the pancreas. AU - Meko,J B, AU - Norton,J A, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 186 EP - 94 JF - Current opinion in general surgery JO - Curr Opin Gen Surg N2 - Pancreatic endocrine tumors are rare, yet can cause significant morbidity due to excessive secretion of hormones. Octreotide is effective in reducing the plasma concentrations of many of these hormones. The availability of potent H2-receptor antagonists and omeprazole has altered the emphasis in patients with Zollinger-Ellison syndrome away from total gastrectomy and towards resection of the gastrinoma for potential cure. Fifty percent of insulinomas and gastrinomas are not evident on preoperative imaging studies, despite their sophistication. Calcium angiography, endoscopic ultrasonography, isotope-labeled octreotide scanning, and injection of methylene blue during secretin angiography are recent imaging modalities that have shown promise in the localization of these tumors. Intraoperative ultrasound has emerged as the best method for operative detection of insulinomas. Duodenotomy and intraoperative endoscopic transillumination are especially important in the surgical management of Zollinger-Ellison syndrome because 30% to 40% of gastrinomas are located in the duodenum. The management of patients with multiple endocrine neoplasia type 1 and Zollinger-Ellison syndrome continues to be controversial. Some advocate an aggressive surgical approach, whereas others have had little success in rendering patients eugastrinemic. SN - 1065-6243 UR - https://www.unboundmedicine.com/medline/citation/7583963/Endocrine_tumors_of_the_pancreas_ L2 - https://medlineplus.gov/pancreaticcancer.html DB - PRIME DP - Unbound Medicine ER -