Localization and resection of @entity7581 in XXXX .

@entity1 @entity4444 @entity5 @entity11384 @entity8579 @entity8243 @entity5616 @entity7581
From 1971-1986, 24 @entity1 were diagnosed as having @entity8579 ( @entity8579 ) and 22 @entity1 had laparotomy. Of this group, gross @entity5 was identified in 15 of 22 @entity1 . Ten of 15 @entity1 had resection of their @entity7581 with the specific aim of curing the disease. This group had responded favorably to either @entity4444 or @entity5616 before operation. Preoperative transhepatic portal venous sampling (PVS) with @entity8243 determinations was performed in six @entity1 ; three @entity1 had this procedure twice. The @entity5 was correctly localized by PVS in five of six @entity1 . In four of six @entity1 , the @entity5 was easily found at surgery. In two of six @entity1 (33%) PVS was vital to intraoperative decisions. Criteria for biochemical cure are normal periodic fasting @entity8243 and @entity11384 infusion tests. Of the 10 @entity1 who had resection for potential cure, two @entity1 failed within 48 hours of surgery on the basis of an elevated fasting serum @entity8243 level in one @entity1 and a positive secretin infusion test in the other @entity1 . Eight @entity1 were considered cured with follow-up from 6 months through 15 years. Of the eight cured @entity1 , the @entity5 were located as follows: four were extraintestinal and extrapancreatic, four were in the duodenal wall, one @entity1 had a @entity5 located in the uncinate process of the pancreas, and one @entity5 was located in a lymph node along the lesser curve of the stomach. Two @entity1 had mobilization of the pancreas and duodenum for a "blind" pancreatoduodenectomy based on preoperative PVS (2 procedures each @entity1 ). In one @entity1 a 3-mm @entity7581 was enucleated from the posterior uncinate process. The second @entity1 had pancreatoduodenectomy with findings of two duodenal wall @entity7581 . Both @entity1 remained cured of @entity8579 beyond 2 years. It is concluded that PVS does indeed locate some @entity5 before operation, even those not easily found at surgery. @entity8579 can be cured by an aggressive approach combining preoperative @entity5 localization and @entity5 resection. Of the eight @entity1 biochemically and perhaps biologically cured, follow-up was greater than four years in five @entity1 , greater than two years in two @entity1 , and beyond six months in one @entity1 .
