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Pancreatic Carcinoid - Treatment
Last reviewed: 04.07.2025
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Carcinoids grow slowly, so radical surgery is often possible. In the presence of multiple metastases in the liver, surgery to remove them is very traumatic. Recently, other methods of eliminating liver metastases have been used - their destruction by selective dearterialization, by local intra-arterial infusion of cytostatic drugs. Palliative surgery and subsequent drug therapy often make it possible to achieve the disappearance of symptoms. In such situations, patient survival of 10 and even 20 years is not uncommon.
In the presence of carcinoid syndrome, the surgical intervention itself is associated with the risk of developing serious complications from the cardiovascular and respiratory systems. Complications are associated not only with the release of serotonin from the tumor, but also with the blockade of enzyme systems involved in its metabolism. To prevent them, patients are given serotonin antagonists - aminazine, deseril, peritol, etc. It is possible that previously absent carcinoid syndrome may appear during surgery. This can lead to the development of cardiovascular and liver failure in the postoperative period, to gastrointestinal tract paresis and other complications.
For conservative treatment of carcinoid tumors, chemotherapeutic agents (5-fluorouracil, cyclophosphamide, streptozotocin), serotonin antagonists (for example, peritol 8-32 mg/day), corticosteroids (prednisolone 5-20 mg/day) are used, symptomatic therapy with antidiarrheal, bronchodilators, antispasmodics, etc. is carried out. Somatostatin, a paninhibitor of external and internal secretion, is promising. There are reports of its reduction in the frequency and severity of hot flashes and diarrhea. Periodically, courses of treatment with nicotinic acid are carried out due to the violation of tryptophan metabolism, which goes to the synthesis of serotonin, in carcinoid tumors.
Products containing large amounts of tryptophan and serotonin are excluded from the diet. Patients should abstain from alcohol.
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