1 Sep 2023Article
Neuroendocrine tumors’ patients treated with somatostatin analogue could complicate with emergency cholecystectomy.
Natale Calomino 1Gianmario Poto 2Ludovico Carbone 2Giulio Bagnacci 3Stefania Piccion 2Eleonora Andreucci 2Lorenzo Nenci 2Luigi Marano 2Luigi Verre 2Roberto Petrioli 4Franco Roviello 2Daniele Marrelli 2
Affiliations
Article Info
1 Department of Medicine, Surgery and Neurosciences, Unit of Hepato-Pancreato-Biliary Surgery, Siena, Italy
2 Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, Siena, Italy
3 Department of Medicine, Surgery and Neurosciences, Unit of Diagnostic Imaging, Siena, Italy
4 Department of Medicine, Surgery and Neurosciences, Unit of Medical Oncology, Siena, Italy
Ann. Ital. Chir., 2023, 94(5), 518-522;
Published: 1 Sep 2023
Copyright © 2023
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
BACKGROUND: Gastro-entero-pancreatic neuroendocrine tumors are gradually seeing their incidence increase, probably due to their low-rate mortality. Surgery and subsequent medical therapy through octeotride and somatostatin analogues is the recommended approach for hypersecretive hormonal forms, showing an effective control of symptoms and improved survival outcomes. AIM: The present study aims to evaluate the occurrence of gallbladder lithiasis, and its complications, in patients underwent upfront surgery for neuroendocrine tumors and subsequent long-term administration of somatostatin analogues. MATERIAL OF STUDY: We included four adults affected by neuroendocrine (gastric, appendiceal and ileal) tumors and without previous evidence of gallbladder stones, who needed an emergency cholecystectomy after long-term somatostatin treatment. RESULTS: The patients showed complicated conditions sustained by cholelithiasis, such as acute cholecystitis, gangrenous cholecystitis, or intestinal occlusion, which required emergency surgery. DISCUSSIONS: Somatostatin analogues may influence the cascade of enzymes that guarantee the gallbladder motility, and consequently cause the precipitation of cholesterol and calcium bilirubinate crystals. Therefore, higher and sustained levels of somatostatin may result in higher rates of gallstone development.
Keywords
- Gallbladder stones
- Neuroendocrine tumors
- Somatostatine analogues