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Surgical treatment and prognosis of gastrinoma.
Best Pract Res Clin Gastroenterol. 2005 Oct; 19(5):799-805.BP

Abstract

Zollinger-Ellison syndrome (ZES) is a clinical syndrome with severe peptic ulcer disease and diarrhea caused by gastric acid hypersecretion secondary to a neuroendocrine tumour that secretes excessive amounts of the hormone gastrin (gastrinoma). Gastrinomas occur in a familial and a sporadic form. Patients with gastrinoma in the familial setting of Multiple Endocrine Neoplasia type 1 (MEN-1) are seldom, if ever, cured of Zollinger-Ellison syndrome by the current non-Whipple operations to remove duodenal and pancreatic gastrinoma. Surgery is currently used in these patients to deal with the malignant nature of pancreatic or duodenal neuroendocrine tumours. Malignant potential is best determined by tumour size. Tumours that are greater than 2 cm in size should be excised. In the sporadic setting, cure occurs in a significant proportion of patients (50%) by surgical resection of gastrinoma. Duodenotomy has improved both the tumour detection rate and the cure rate and should be routinely done. Whipple pancreaticoduodenectomy results in the highest probability of cure in both sporadic and MEN-1 gastrinoma patients as it removes the entire gastrinoma triangle. However, the excellent long-term survival of these patients with lesser operations and the increased operative mortality and long-term morbidity of Whipple make its current role unclear until further studies are done.

Authors+Show Affiliations

Department of Surgery, Stanford University Medical Center, Room H3591, 300 Pasteur Drive, Stanford, CA 94305-5641, USA.

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

16253901

Citation

Norton, Jeffrey A.. "Surgical Treatment and Prognosis of Gastrinoma." Best Practice & Research. Clinical Gastroenterology, vol. 19, no. 5, 2005, pp. 799-805.
Norton JA. Surgical treatment and prognosis of gastrinoma. Best Pract Res Clin Gastroenterol. 2005;19(5):799-805.
Norton, J. A. (2005). Surgical treatment and prognosis of gastrinoma. Best Practice & Research. Clinical Gastroenterology, 19(5), 799-805.
Norton JA. Surgical Treatment and Prognosis of Gastrinoma. Best Pract Res Clin Gastroenterol. 2005;19(5):799-805. PubMed PMID: 16253901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical treatment and prognosis of gastrinoma. A1 - Norton,Jeffrey A, PY - 2005/10/29/pubmed PY - 2006/1/28/medline PY - 2005/10/29/entrez SP - 799 EP - 805 JF - Best practice & research. Clinical gastroenterology JO - Best Pract Res Clin Gastroenterol VL - 19 IS - 5 N2 - Zollinger-Ellison syndrome (ZES) is a clinical syndrome with severe peptic ulcer disease and diarrhea caused by gastric acid hypersecretion secondary to a neuroendocrine tumour that secretes excessive amounts of the hormone gastrin (gastrinoma). Gastrinomas occur in a familial and a sporadic form. Patients with gastrinoma in the familial setting of Multiple Endocrine Neoplasia type 1 (MEN-1) are seldom, if ever, cured of Zollinger-Ellison syndrome by the current non-Whipple operations to remove duodenal and pancreatic gastrinoma. Surgery is currently used in these patients to deal with the malignant nature of pancreatic or duodenal neuroendocrine tumours. Malignant potential is best determined by tumour size. Tumours that are greater than 2 cm in size should be excised. In the sporadic setting, cure occurs in a significant proportion of patients (50%) by surgical resection of gastrinoma. Duodenotomy has improved both the tumour detection rate and the cure rate and should be routinely done. Whipple pancreaticoduodenectomy results in the highest probability of cure in both sporadic and MEN-1 gastrinoma patients as it removes the entire gastrinoma triangle. However, the excellent long-term survival of these patients with lesser operations and the increased operative mortality and long-term morbidity of Whipple make its current role unclear until further studies are done. SN - 1521-6918 UR - https://www.unboundmedicine.com/medline/citation/16253901/Surgical_treatment_and_prognosis_of_gastrinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-6918(05)00088-0 DB - PRIME DP - Unbound Medicine ER -