Pancreaticoduodenectomy for selected periampullary neuroendocrine tumors: Fifty patients

Giao Q. Phan, Charles J. Yeo, John L. Cameron, Michael M. Maher, Ralph H. Hruban, Robert Udelsman

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Most resectable pancreatic or peripancreatic neuroendocrine tumors are treated by enucleation or distal pancreatectomy. A minority of tumors may require pancreaticoduodenectomy for complete tumor excision because of their large size, location, or lymph node involvement. Methods. This study reviews the management of 50 patients treated by pancreaticoduodenectomy for periampullary neuroendocrine tumors between 1962 and 1996 at a single institution. Results. There were 30 men and 20 women with a mean age of 52 ± 2 years. Functional tumors were resected in 17 patients: insulinoma, seven tumors; gastrinoma, eight tumors; vipoma, one tumor; and glucagonoma, one tumor. Tumors were classified as malignant in 29 patients and benign in 21. The median intraoperative blood loss was 800 ml, and the median number of units of blood transfused was zero. The postoperative length of stay was 20 ± 2 days. Postoperative morbidity included 11 patients (24 %) with a pancreatic fistula and four patients (8%) with a biliary fistula. There was one in-hospital death (2%), in 1967. The actuarial survival rates at 2, 5, and 7 years are 81%, 73%, and 65%, respectively. Patients with benign tumors had a significantly improved 5- year survival rate (94 %) compared with those with malignant tumors (61%; p = 0.03). Conclusions. Selected patients with periampullary neuroendocrine tumors can be managed successfully by pancreaticoduodenectomy, with low mortality and acceptable morbidity rates.

Original languageEnglish (US)
Pages (from-to)989-997
Number of pages9
JournalSurgery
Volume122
Issue number6
DOIs
StatePublished - Dec 1997

ASJC Scopus subject areas

  • Surgery

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