International expert consensus on perioperative management of carcinoid crisis

@article{hallet2026international,
  title = {{International expert consensus on perioperative management of carcinoid crisis}},
  author = {Julie Hallet and Fahad Alam and Stefano Partelli and Jonathan Koea and Flavio Rocha and Stephanie Ladowski and Jaydira Del Rivero and Chadi Saliba and Jessica Armah and Rodney Pommier and S Ahmed and S Ahmed and N Begum and S Bhatnagar and V Boyle and J Chan and C Clarke and J Cloyd and M Cukier and M Cummins and N Devaud and T Donaldson and A Frilling and A Gangi and S Gaujoux and V Gottomukkala and T Halfdanaron and K Hand and J Herman and J R Howe and E T Janson and M A Jara and R Kotha and J Kwan and F Mercier and W Meyer-Rochow and S Pattison and L Rahmanni and N Rashidian and B Riedel and S Singh and S L Solanki and J Soliz and K Soreide and S Stättner and H Stuart and C Teh and E N van Dijkum and L Yen},
  journal = {BJS Open},
  year = {2026},
  month = oct,
  doi = {10.1093/bjsopen/zrag159},
  url = {https://doi.org/10.1093/bjsopen/zrag159},
  note = {CC BY-NC 4.0},
}

TY  - JOUR
TI  - International expert consensus on perioperative management of carcinoid crisis
AU  - Julie Hallet
AU  - Fahad Alam
AU  - Stefano Partelli
AU  - Jonathan Koea
AU  - Flavio Rocha
AU  - Stephanie Ladowski
AU  - Jaydira Del Rivero
AU  - Chadi Saliba
AU  - Jessica Armah
AU  - Rodney Pommier
AU  - S Ahmed
AU  - S Ahmed
AU  - N Begum
AU  - S Bhatnagar
AU  - V Boyle
AU  - J Chan
AU  - C Clarke
AU  - J Cloyd
AU  - M Cukier
AU  - M Cummins
AU  - N Devaud
AU  - T Donaldson
AU  - A Frilling
AU  - A Gangi
AU  - S Gaujoux
AU  - V Gottomukkala
AU  - T Halfdanaron
AU  - K Hand
AU  - J Herman
AU  - J R Howe
AU  - E T Janson
AU  - M A Jara
AU  - R Kotha
AU  - J Kwan
AU  - F Mercier
AU  - W Meyer-Rochow
AU  - S Pattison
AU  - L Rahmanni
AU  - N Rashidian
AU  - B Riedel
AU  - S Singh
AU  - S L Solanki
AU  - J Soliz
AU  - K Soreide
AU  - S Stättner
AU  - H Stuart
AU  - C Teh
AU  - E N van Dijkum
AU  - L Yen
PY  - 2026
DA  - 2026/10/27
JO  - BJS Open
DO  - 10.1093/bjsopen/zrag159
UR  - https://doi.org/10.1093/bjsopen/zrag159
AB  - Background: Carcinoid crisis is a critical concern for patients with neuroendocrine tumours undergoing invasive procedures. Guidance is needed to standardize and optimize perioperative care for patients at risk of carcinoid crisis. Consensus-based expert recommendations were developed for the perioperative management of carcinoid crisis among patients with midgut and bronchopulmonary neuroendocrine tumours undergoing non-cardiac surgery.  Methods: A modified Delphi approach was used with four rounds of voting to reach expert consensus on statements about perioperative management of carcinoid crisis. A multidisciplinary international panel of 44 experts was formed, and 3 patient partners were engaged. Statements addressing preoperative, intraoperative, and postoperative considerations were created. Panellists rated statements on a Likert scale (from 1 to 7). Three additional rounds of iterative rating and feedback were completed anonymously. Consensus was defined with median score between 5 and 7, and ≤ 13 panellists rating outside the score category containing the median.  Results: Final consensus was reached on 41 statements. Of these, 12 focused on preoperative work-up and optimization, 27 on intraoperative management including monitoring, prophylaxis, and treatment of crisis, and 2 on postoperative management. The principal practice-shifting recommendations were that somatostatin analogues are not necessary for prophylaxis before surgery or on the day of operation, and treatment in the event of carcinoid crisis should start with vasopressors, with short-acting somatostatin analogues used as an adjunct.  Conclusion: Using modified Delphi methodology, recommendations to guide the perioperative management of carcinoid crisis were developed. Considering the importance of carcinoid crisis on the management and outcomes of patients undergoing surgical resection for neuroendocrine tumours, this guidance can help standardize care and optimize outcomes.
SN  - 2474-9842
ER  -