Surgical experience with pancreatic islet-cell tumors.

Publication/Presentation Date

10-1-1993

Abstract

OBJECTIVE: To review the surgical management of pancreatic islet-cell tumors, with attention to preoperative localization, surgical therapy, and postoperative survival.

DESIGN: Consecutive case series of patients treated surgically for pancreatic islet-cell tumor.

SETTING: The Johns Hopkins Hospital, a large teaching hospital in Baltimore, Md, serving both as a primary and tertiary care center.

PATIENTS: Thirty-seven patients with pancreatic islet-cell tumors treated surgically between 1979 and 1990.

MAIN OUTCOME MEASURES: Success of preoperative localization studies, types of operations performed, and postoperative survival.

RESULTS: Preoperative computed tomography correctly localized the tumor in 20 of 34 patients (59%); angiography in 21 of 28 patients (75%), and the combination of computed tomography and angiography in 23 of 28 patients (82%). Benign islet-cell tumors were found in 19 patients, and malignant tumors in 18 patients. Twenty-four patients (65%) had functional tumors. The proportion of patients with nonfunctioning tumors increased from 0% before 1984, to 43% from 1985 to 1990. Surgical therapy was curative in 27 patients and palliative in 10. The most commonly performed operative procedures were tumor enucleation (11 patients [30%]), distal pancreatectomy (10 patients [27%]). There was no operative mortality. The actuarial survival at 40 months was 100% in patients with benign tumors and significantly lower (66%) in patients with malignant tumors.

CONCLUSIONS: This experience from a single institution underscores the role of preoperative localization studies and appropriate surgical management of these rare tumors.

Volume

128

Issue

10

First Page

1143

Last Page

1148

ISSN

0004-0010

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

8105769

Department(s)

Administration and Leadership

Document Type

Article

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