When total pancreatectomy is planned, the pancreas is not divided but used for traction as the head of the pancreas and the duodenum are excised in the Whipple operation. Systemic symptoms associated with the gastrinoma, a hormone-producing islet cell tumor, may be controlled partially, but rarely completely, for years by resection of a solitary tumor. Those associated with other apudomas (vipoma, glucagonoma, insulinoma, and so forth) may respond to local excision in the absence of malignancy and metastases.