[Usefulness and limits of intraoperative hormone determination in the surgery of endocrine duodeno-pancreatic tumors. Experience of 74 cases].
74 patients underwent surgery for organic hyperinsulinism (51 cases) or for Zollinger-Ellison syndrome (23 cases). 20 minutes after removal of the specimen, quick intra-operative hormone measurements were done in the systemic and portal blood as well, with intra-operative secretin stimulation test for gastrinoma(s), to assess completeness of surgery. Results accurately predicted cure (all insulinomas) or non-cure (half of gastrinomas) of the disease. Stumbling-blocks of the method are: a) the possibility of normal hormone base line levels at the time of surgery; b) the importance of secretion of proinsulin products by insulinomas. Those products are not taken in account by the modern assay technique with monoclonal antibodies (IRMA). Basal and stimulated portal measurements are more sensitive than measurements in the systematic blood.
Proye
C
C
Service de Cirurgie Générale et Endocrinienne CHU de Lille.
D'Herbomez
M
M
Hautier
M B
MB
Zaitouni
C
C
Ali
M
M
D015408:Gastrinoma / Q000601:surgery; D005768:Gastrointestinal Hormones / Q000097:blood* / Q000378:metabolism; D005935:Glucagonoma / Q000601:surgery; D006801:Humans; D007340:Insulinoma / Q000601:surgery; D007432:Intraoperative Period; D010187:Pancreatic Hormones / Q000097:blood* / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000601:surgery*; D010191:Pancreatic Polypeptide / Q000378:metabolism; D011446:Prospective Studies; D003969:Vipoma / Q000601:surgery
D005768:Gastrointestinal Hormones; D010187:Pancreatic Hormones; D010191:Pancreatic Polypeptide
Utilité et limites des dosages hormonaux per-opératoires dans la chirurgie des tumeurs endocrines duodéno-pancréatiques. Expérience de 74 cas.