Abstract
It has become increasingly clear that duodenal gastrinomas are the most common cause of Zollinger-Ellison syndrome (ZES). However, attempts to find these tumors before and during surgery for ZES have had limited success until duodenotomy (opening the duodenum) was described. The routine use of duodenotomy in patients with non-familial gastrinoma increases the number of duodenal tumors found, and the immediate and long-term cure-rate. The increase in cure-rate appears to be secondary to increased detection of small, previously undetectable duodenal gastrinomas. Duodenotomy detects small tumors (<1 cm) in the proximal duodenum. It does not detect more duodenal gastrinomas per patient, nor does it detect tumors in unusual duodenal locations. Duodenotomy decreases the death-rate associated with these tumors. However, it has not affected the rate of development of liver metastases. Duodenotomy is a critical method to find duodenal gastrinomas. It should be routinely performed in all surgery to find and remove gastrinoma for cure of ZES.
TY - JOUR
T1 - Surgery and prognosis of duodenal gastrinoma as a duodenal neuroendocrine tumor.
A1 - Norton,Jeffrey A,
PY - 2005/10/29/pubmed
PY - 2006/1/28/medline
PY - 2005/10/29/entrez
SP - 699
EP - 704
JF - Best practice & research. Clinical gastroenterology
JO - Best Pract Res Clin Gastroenterol
VL - 19
IS - 5
N2 - It has become increasingly clear that duodenal gastrinomas are the most common cause of Zollinger-Ellison syndrome (ZES). However, attempts to find these tumors before and during surgery for ZES have had limited success until duodenotomy (opening the duodenum) was described. The routine use of duodenotomy in patients with non-familial gastrinoma increases the number of duodenal tumors found, and the immediate and long-term cure-rate. The increase in cure-rate appears to be secondary to increased detection of small, previously undetectable duodenal gastrinomas. Duodenotomy detects small tumors (<1 cm) in the proximal duodenum. It does not detect more duodenal gastrinomas per patient, nor does it detect tumors in unusual duodenal locations. Duodenotomy decreases the death-rate associated with these tumors. However, it has not affected the rate of development of liver metastases. Duodenotomy is a critical method to find duodenal gastrinomas. It should be routinely performed in all surgery to find and remove gastrinoma for cure of ZES.
SN - 1521-6918
UR - https://www.unboundmedicine.com/medline/citation/16253894/Surgery_and_prognosis_of_duodenal_gastrinoma_as_a_duodenal_neuroendocrine_tumor_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-6918(05)00084-3
DB - PRIME
DP - Unbound Medicine
ER -