PMID- 30288555
OWN - NLM
STAT- MEDLINE
DCOM- 20190626
LR  - 20200225
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 43
IP  - 2
DP  - 2019 Feb
TI  - Results of Duodenopancreatic Reoperations in Multiple Endocrine Neoplasia Type 1.
PG  - 552-558
LID - 10.1007/s00268-018-4809-1 [doi]
AB  - BACKGROUND: To evaluate the outcome of duodenopancreatic reoperations in patients 
      with multiple endocrine neoplasia type 1 (MEN1). METHODS: MEN1 patients who 
      underwent reoperations for duodenopancreatic neuroendocrine neoplasms (dpNENs) 
      were retrieved from a prospective database and retrospectively analyzed. RESULTS: 
      Twelve of 101 MEN1 patients underwent up to three reoperations, resulting in a 
      total of 18 reoperations for dpNEN recurrence. Patients initially underwent 
      either formal pancreatic resections (n = 7), enucleations (n = 3), or duodenotomy 
      with lymphadenectomy for either NF-pNEN (seven patients), Zollinger-Ellison 
      syndrome (ZES, three patients), organic hyperinsulinism (one patient) or VIPoma 
      (one patient). Six patients had malignant dpNENs with lymph node (n = 5) and/or 
      liver metastases (n = 2). The indication of reoperations was NF-pNEN (five 
      patients), ZES (five patients), organic hyperinsulinism (one patient), and 
      recurrent VIPoma (one patient). Median time to first reoperation was 67.5 (range 
      6-251) months. Five patients required a second duodenopancreatic reoperation for 
      60-384 months after initial surgery, and one patient underwent a third 
      reoperation after 249 months. The rate of complications (Clavien-Dindo >/=3) was 
      28%. Four patients required completion pancreatectomy. Six patients developed 
      pancreoprivic diabetes. After a median follow-up of 18 (6-34) years after initial 
      surgery, ten of 12 patients are alive, one died of metastatic pancreatic VIPoma, 
      and one died of metastatic thymic NEN. CONCLUSION: Reoperations are frequently 
      necessary for dpNEN in MEN1 patients, but are not associated with an increased 
      perioperative morbidity in specialized centers. Organ-sparing resections should 
      be preferred as initial duodenopancreatic procedures to maintain pancreatic 
      function and avoid completion pancreatectomy.
FAU - Albers, Max B
AU  - Albers MB
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany. albersm@med.uni-marburg.de.
FAU - Manoharan, Jerena
AU  - Manoharan J
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany.
FAU - Bollmann, Carmen
AU  - Bollmann C
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany.
FAU - Chlosta, Maximilian P
AU  - Chlosta MP
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany.
FAU - Holzer, Katharina
AU  - Holzer K
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany.
FAU - Bartsch, Detlef K
AU  - Bartsch DK
AD  - Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University of 
      Marburg, Baldingerstr, 35043, Marburg, Germany.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adult
MH  - Duodenal Neoplasms/*surgery
MH  - Duodenum/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*surgery
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/*surgery
MH  - Prospective Studies
MH  - *Reoperation
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2018/10/06 06:00
MHDA- 2019/06/27 06:00
CRDT- 2018/10/06 06:00
PHST- 2018/10/06 06:00 [pubmed]
PHST- 2019/06/27 06:00 [medline]
PHST- 2018/10/06 06:00 [entrez]
AID - 10.1007/s00268-018-4809-1 [pii]
AID - 10.1007/s00268-018-4809-1 [doi]
PST - ppublish
SO  - World J Surg. 2019 Feb;43(2):552-558. doi: 10.1007/s00268-018-4809-1.