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THE EFFECT OF ENDOSCOPIC ULTRASOUND ON THE SURGICAL MANAGEMENT OF PANCREATIC NEUROENDOCRINE TUMORS
F Alsohaibani1, D Bigam2, N Kneteman2, J Shapiro2, G l Sandha1
University of Alberta, Edmonton
BACKGROUND: Endoscopic ultrasound (EUS) is accurate in diagnosing pancreatic neuro-endocrine tumors (NET). We assessed whether EUS information had an effect on the surgical management of NET.
METHOD: This is a retrospective review of patients who underwent EUS for suspected pancreatic NET to assess whether endosonographic interpretation altered the extent of surgical intervention.
RESULTS: Between 02/2004 and 09/2007, 16 patients underwent EUS for suspected NET of the pancreas. There were 10 females and the mean age was 47 years (range 23-69 years). Eight patients (50%) had MEN I. NET were seen with CT scan in 12/15 patients (80%) and with EUS in 14/16 patients (88%). One patient could not fit into the CT scanner. This patient had 5 NET on EUS. Another patient with a normal CT scan was identified to have a single NET on EUS. Three patients with 1-2 NET on CT scan were found to have 5-8 NET on EUS. EUS altered surgical management in 5/16 patients (31%) either by identifying NET or finding multiple NET that were not appreciated on CT scan.
CONCLUSION: EUS is useful in the pre-operative assessment of pancreatic NET by providing information that influences the decision for surgical intervention or change the extent of the planned surgery.