[Treatment for pancreatic endocrine tumors with or without multiple endocrine neoplasia type 1]

Recent strategies for the treatment of pancreatic endocrine tumors are described. Most cases are metastatic, and liver metastasis is the most significant prognostic factor. Thus curative resection before liver metastasis develops based on the localization of the tumors with the SASI test is the standard strategy. Subtotal distal pancreatectomy or pancreas-preserving total duodenectomy is indicated for multiple pancreatic endocrine tumors and multiple duodenal gastrinomas, respectively, for patients with multiple endocrine neoplasia type 1.