Tags

Type your tag names separated by a space and hit enter

Reoperative surgery in sporadic Zollinger-Ellison Syndrome: longterm results.
J Am Coll Surg. 2009 May; 208(5):718-22; discussion 722-4.JA

Abstract

BACKGROUND

Most patients with Zollinger-Ellison Syndrome (ZES), even those in whom gastrinoma is found and resected at initial operation, will suffer from persistent or recurrent disease in longterm followup. There is currently no consensus about managing patients with recurrent or persistent ZES. Our unit has historically maintained an aggressive approach toward monitoring and reoperation for patients with sporadic ZES.

STUDY DESIGN

We performed a review of a consecutive series of patients evaluated and managed at our institution between 1970 and 2007 for ZES. "Biochemical cure" was defined as normal serum gastrin assays and negative imaging studies. Reoperations were performed for elevations in serum gastrin assays and positive findings on imaging studies.

RESULTS

Fifty-two patients with sporadic ZES were analyzed. Median followup was 14 years. Among patients with sporadic ZES, 37 patients underwent operative management. The most common operations were resection of duodenal gastrinoma (n=8) and total gastrectomy (n=7). Nine patients underwent 15 reoperations for recurrent or persistent disease. "Biochemical cure" was obtained in four patients (44%) undergoing reoperation for ZES. Three of these patients remained without evidence of recurrence at 4, 9, and 12 years after their curative re-resection. Only one of nine patients who underwent reoperation died of metastatic gastrinoma.

CONCLUSIONS

Primary and reoperative surgery in patients with sporadic ZES results in a significant rate of "biochemical cure." In selected patients with recurrent or persistent disease, reoperation for resection of gastrinoma is associated with excellent longterm survival and is warranted.

Authors+Show Affiliations

Department of Surgery, Division of Surgical Oncology, University of Florida, Gainesville, FL 32610, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19476823

Citation

Grobmyer, Stephen R., et al. "Reoperative Surgery in Sporadic Zollinger-Ellison Syndrome: Longterm Results." Journal of the American College of Surgeons, vol. 208, no. 5, 2009, pp. 718-22; discussion 722-4.
Grobmyer SR, Vogel SB, McGuigan JE, et al. Reoperative surgery in sporadic Zollinger-Ellison Syndrome: longterm results. J Am Coll Surg. 2009;208(5):718-22; discussion 722-4.
Grobmyer, S. R., Vogel, S. B., McGuigan, J. E., Copeland, E. M., & Hochwald, S. N. (2009). Reoperative surgery in sporadic Zollinger-Ellison Syndrome: longterm results. Journal of the American College of Surgeons, 208(5), 718-22; discussion 722-4. https://doi.org/10.1016/j.jamcollsurg.2008.11.017
Grobmyer SR, et al. Reoperative Surgery in Sporadic Zollinger-Ellison Syndrome: Longterm Results. J Am Coll Surg. 2009;208(5):718-22; discussion 722-4. PubMed PMID: 19476823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reoperative surgery in sporadic Zollinger-Ellison Syndrome: longterm results. AU - Grobmyer,Stephen R, AU - Vogel,Stephen B, AU - McGuigan,James E, AU - Copeland,Edward M, AU - Hochwald,Steven N, PY - 2008/11/25/received PY - 2008/11/25/revised PY - 2008/11/26/accepted PY - 2009/5/30/entrez PY - 2009/5/30/pubmed PY - 2009/6/19/medline SP - 718-22; discussion 722-4 JF - Journal of the American College of Surgeons JO - J. Am. Coll. Surg. VL - 208 IS - 5 N2 - BACKGROUND: Most patients with Zollinger-Ellison Syndrome (ZES), even those in whom gastrinoma is found and resected at initial operation, will suffer from persistent or recurrent disease in longterm followup. There is currently no consensus about managing patients with recurrent or persistent ZES. Our unit has historically maintained an aggressive approach toward monitoring and reoperation for patients with sporadic ZES. STUDY DESIGN: We performed a review of a consecutive series of patients evaluated and managed at our institution between 1970 and 2007 for ZES. "Biochemical cure" was defined as normal serum gastrin assays and negative imaging studies. Reoperations were performed for elevations in serum gastrin assays and positive findings on imaging studies. RESULTS: Fifty-two patients with sporadic ZES were analyzed. Median followup was 14 years. Among patients with sporadic ZES, 37 patients underwent operative management. The most common operations were resection of duodenal gastrinoma (n=8) and total gastrectomy (n=7). Nine patients underwent 15 reoperations for recurrent or persistent disease. "Biochemical cure" was obtained in four patients (44%) undergoing reoperation for ZES. Three of these patients remained without evidence of recurrence at 4, 9, and 12 years after their curative re-resection. Only one of nine patients who underwent reoperation died of metastatic gastrinoma. CONCLUSIONS: Primary and reoperative surgery in patients with sporadic ZES results in a significant rate of "biochemical cure." In selected patients with recurrent or persistent disease, reoperation for resection of gastrinoma is associated with excellent longterm survival and is warranted. SN - 1879-1190 UR - https://www.unboundmedicine.com/medline/citation/19476823/Reoperative_surgery_in_sporadic_Zollinger_Ellison_Syndrome:_longterm_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(09)00047-7 DB - PRIME DP - Unbound Medicine ER -