What are the guidelines on the treatment of pancreatic gastrinoma?

Updated: Dec 23, 2018
  • Author: Evan S Ong, MD, MS; more...
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Recommendations for gastrinoma treatment include the following:

  • Manage gastric hypersecretion with proton pump inhibitors; consider octreotide or lanreotide

  • Occult tumors: Observation or exploratory surgery, including duodenotomy and intraoperative ultrasound with enucleation; local resection if tumors identified, and removal of periduodenal nodes

  • Duodenum tumors: Duodenotomy and intraoperative ultrasound with local resection or enucleation and periduodenal node dissection

  • Tumors at head of pancreas: Exophytic or peripheral tumors require enucleation and periduodenal node dissection; deeper or invasive tumors or those with proximity to the main pancreatic duct require pancreatoduodenectomy

  • Distal tumors: Distal pancreatectomy with or without splenectomy.

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