Neuroendocrine tumors' patients treated with somatostatin analogue could complicate with emergencycholecystectomy

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 forhy persecretive 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 under-went upfront surgery for neuroendocrine tumors and subsequent long-term administration of somatostatin analogues. MATERIAL OFSTUDY: We included four adults affected by neuroendocrine (gastric, appendiceal and ileal) tumors andwithout previous evidence of gallbladder stones, who needed an emergency cholecystectomy after long-term somatostatintreatment. RESULTS: The patients showed complicated conditions sustained by cholelithiasis, such as acute cholecystitis, gangrenouscholecystitis, 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. CONCLUSIONS: The prophylactic cholecystectomy, during upfront surgery for neuroendocrine tumors, might prevent an emergency cholecystectomy for gallstones complications