Surgical management of pancreatic neuroendocrine neoplasms

Pancreatic neuroendocrine neoplasms (pNENs) can be divided into functional and non functional. Insulinomas, gastrinomas, glucagonomas and VIPomas are the common types of pNENs. Radical resection is the only way for curing pNENs or for a long time survival of patients. The basic surgical procedures for pNENs are consist of local resection (tumor enucleation) or anatomical resection ［pancreatoduodenectomy (standard or pylorus preserving pancreatoduodenectomy), distal pancreatectomy (combined with splenectomy or spleen preserving pancreatectomy) and middle segmental pancreatectomy］. Liver is the most common site for metastases. Surgical resection is the method of choice for liver metastases. Radiofrequency ablation, transcatheter arterial chemoembolization and liver transplantation could be the adjunctive therapies.