Background: The optimal treatment for hepatic metastases from neuroendocrine tumors remains controversial because of the often indolent nature of these tumors. We sought to determine the effect of 3 major treatment modalities including medical therapy, hepatic artery embolization, and surgical resection, ablation, or both in patients with liver-only neuroendocrine metastases, with the hypothesis that surgical treatment is associated with improvement in survival.Design: Retrospective study.Setting: Tertiary care center.Patients: Patients with metastatic liver-only neuroendocrine tumors were identified from hospital records.Interventions: Patients were subdivided into those receiving medical therapy, hepatic artery embolization, or surgical management. Main Outcome Measures:Effect of treatment on survival and palliation of symptoms was analyzed.

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Diabetic gastroparesis patients respond best to GES. Responders tend to have more severe vomiting preoperatively. Patients with idiopathic gastroparesis who do not experience severe vomiting should be cautioned about a potentially higher rate of poor response to GES and may be better served with alternative treatments.

Preoperative CT scanning in patients with presumed appendicitis should be used selectively as widespread utilization may adversely affect outcomes. The potential negative impact of CT imaging includes a delay in operative intervention and a potentially higher perforation rate.