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Curative resection of microgastrinomas based on the intraoperative secretin test.
World J Surg. 2000 Nov; 24(11):1425-30.WJ

Abstract

The intravenous secretin injection test (secretin test) has been used for the differential diagnosis of gastrinoma. In this study we report that the intraoperative secretin test (IOS test) is also useful for determining the extent of curability in patients with Zollinger-Ellison syndrome (ZES). Twelve patients with ZES underwent surgical exploration and the IOS test. The results of the IOS test were obtained by rapid radioimmunoassay of the serum gastrin level (IRG) within 60 minutes. The test was diagnosed as negative when the maximum increase of serum IRG was less than 80 pg/ml and also less than 20% of the basal serum IRG level. Three of the twelve patients underwent pancreatoduodenectomy (PD), and two patients underwent distal pancreatectomy. Extirpation of duodenal tumors with dissection of regional lymph nodes was performed in seven patients. In two of the seven patients the IOS test remained positive after extirpation of the duodenal tumors and the dissection of regional lymph nodes. In one patient PD was performed on the basis of the positive results, and the IOS test became negative after PD. In the other patient, two tiny metastatic liver tumors were identified and were resected, but the IOS test did not become negative. We closed the abdomen in 11 patients when we obtained negative results from the IOS test. The results of the IOS test were almost identical to the data obtained by the standard assay postoperatively. The serum IRG levels of all but one patient fell to the normal level, and the secretin test became negative postoperatively. The IOS test is thus useful and indispensable for curative resection of microgastrinomas in patients with ZES.

Authors+Show Affiliations

Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11038217

Citation

Kato, M, et al. "Curative Resection of Microgastrinomas Based On the Intraoperative Secretin Test." World Journal of Surgery, vol. 24, no. 11, 2000, pp. 1425-30.
Kato M, Imamura M, Hosotani R, et al. Curative resection of microgastrinomas based on the intraoperative secretin test. World J Surg. 2000;24(11):1425-30.
Kato, M., Imamura, M., Hosotani, R., Shimada, Y., Doi, R., Itami, A., Komoto, I., KosakaM T, T., & Konishi, J. (2000). Curative resection of microgastrinomas based on the intraoperative secretin test. World Journal of Surgery, 24(11), 1425-30.
Kato M, et al. Curative Resection of Microgastrinomas Based On the Intraoperative Secretin Test. World J Surg. 2000;24(11):1425-30. PubMed PMID: 11038217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Curative resection of microgastrinomas based on the intraoperative secretin test. AU - Kato,M, AU - Imamura,M, AU - Hosotani,R, AU - Shimada,Y, AU - Doi,R, AU - Itami,A, AU - Komoto,I, AU - KosakaM T,T, AU - Konishi,J, PY - 2000/10/19/pubmed PY - 2001/2/28/medline PY - 2000/10/19/entrez SP - 1425 EP - 30 JF - World journal of surgery JO - World J Surg VL - 24 IS - 11 N2 - The intravenous secretin injection test (secretin test) has been used for the differential diagnosis of gastrinoma. In this study we report that the intraoperative secretin test (IOS test) is also useful for determining the extent of curability in patients with Zollinger-Ellison syndrome (ZES). Twelve patients with ZES underwent surgical exploration and the IOS test. The results of the IOS test were obtained by rapid radioimmunoassay of the serum gastrin level (IRG) within 60 minutes. The test was diagnosed as negative when the maximum increase of serum IRG was less than 80 pg/ml and also less than 20% of the basal serum IRG level. Three of the twelve patients underwent pancreatoduodenectomy (PD), and two patients underwent distal pancreatectomy. Extirpation of duodenal tumors with dissection of regional lymph nodes was performed in seven patients. In two of the seven patients the IOS test remained positive after extirpation of the duodenal tumors and the dissection of regional lymph nodes. In one patient PD was performed on the basis of the positive results, and the IOS test became negative after PD. In the other patient, two tiny metastatic liver tumors were identified and were resected, but the IOS test did not become negative. We closed the abdomen in 11 patients when we obtained negative results from the IOS test. The results of the IOS test were almost identical to the data obtained by the standard assay postoperatively. The serum IRG levels of all but one patient fell to the normal level, and the secretin test became negative postoperatively. The IOS test is thus useful and indispensable for curative resection of microgastrinomas in patients with ZES. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/11038217/Curative_resection_of_microgastrinomas_based_on_the_intraoperative_secretin_test_ DB - PRIME DP - Unbound Medicine ER -