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- W4285133617 abstract "Pancreatic resection is the mainstay treatment of pancreatic neuroendocrine neoplasm (PNEN) for curative intent or symptom control. In this chapter, we describe the indication of pancreatic resection for PNENs and procedures based on the need for systematic lymph node dissection (LND). Recent guidelines accept initial observation for incidentally discovered small non-functional PNEN (NF-PNEN) without malignant signs. Otherwise, formal pancreatic resection with systematic LND is recommended (pancreatoduodenectomy for head/uncinate tumor and distal pancreatectomy for body/tail tumor). For hormone-secreting functional PNENs, pancreatic resection is generally recommended because hormonal symptoms severely impair the patients’ quality of life. Tumor enucleation without systematic LND can be indicated for insulinoma, whereas formal pancreatectomy with systematic LND is recommended for gastrinoma. When systematic LND is omitted, sampling peritumoral lymph nodes should be performed for accurate staging. In the setting of unresectable distant metastasis, the significance of resection of the primary tumor has been controversial. For patients with resectable pancreatic head tumor and liver metastasis, staged operation of liver metastasectomy followed by pancreatoduodenectomy is recommended to avoid biliary infection after bilioenteric anastomosis. Survival benefit of resection of poorly-differentiated pancreatic neuroendocrine carcinoma has not been demonstrated due to the extremely poor prognosis." @default.
- W4285133617 created "2022-07-14" @default.
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- W4285133617 date "2022-01-01" @default.
- W4285133617 modified "2023-09-26" @default.
- W4285133617 title "Pancreatic Resection for Neuroendocrine Neoplasms of the Pancreas" @default.
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- W4285133617 doi "https://doi.org/10.1007/978-981-19-0063-1_52" @default.
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