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Curative resection of multiple gastrinomas aided by selective arterial secretin injection test and intraoperative secretin test.
Ann Surg. 1989 Dec; 210(6):710-8.AnnS

Abstract

Recently a number of surgeons have recommended radical resection of gastrinomas in Zollinger-Ellison syndrome (ZES). We have developed a useful technique for preoperative localization of gastrinomas--the selective arterial secretin injection test (SASI)--and we recommend an intraoperative secretin test (IOS) for deciding the radicality of resection of gastrinomas. Here the results of SASI and IOS tests in 11 patients with ZES are examined and compared with the results of other techniques. The SASI test localized gastrinomas in all of the patients, while the sensitivity of ultrasonography, computed tomography, arteriography, or portal venous blood samplings was between 1/11 and 5/11. On the basis of the results of the SASI test, radical resection of gastrinoma was performed in four patients (three pancreatoduodenectomies and one extirpation). After pancreatoduodenectomy, immunohistologic study of the specimen revealed multiple microgastrinomas and lymph node metastases in two patients and the coexistence of a microgastrinoma and a gastinoma in one patient. The IOS test was useful in the estimation of the advisability of radicality, and in two patients total gastrectomy was not performed because of the results of the IOS test. These four patients are well and have returned to work, and their serum gastrin levels are below 35 pg/mL. Thus we believe SASI and IOS tests are helpful for planning curative resection of gastrinomas.

Authors+Show Affiliations

Department of Surgery, Faculty of Medicine, Kyoto University, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2589884

Citation

Imamura, M, et al. "Curative Resection of Multiple Gastrinomas Aided By Selective Arterial Secretin Injection Test and Intraoperative Secretin Test." Annals of Surgery, vol. 210, no. 6, 1989, pp. 710-8.
Imamura M, Takahashi K, Isobe Y, et al. Curative resection of multiple gastrinomas aided by selective arterial secretin injection test and intraoperative secretin test. Ann Surg. 1989;210(6):710-8.
Imamura, M., Takahashi, K., Isobe, Y., Hattori, Y., Satomura, K., & Tobe, T. (1989). Curative resection of multiple gastrinomas aided by selective arterial secretin injection test and intraoperative secretin test. Annals of Surgery, 210(6), 710-8.
Imamura M, et al. Curative Resection of Multiple Gastrinomas Aided By Selective Arterial Secretin Injection Test and Intraoperative Secretin Test. Ann Surg. 1989;210(6):710-8. PubMed PMID: 2589884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Curative resection of multiple gastrinomas aided by selective arterial secretin injection test and intraoperative secretin test. AU - Imamura,M, AU - Takahashi,K, AU - Isobe,Y, AU - Hattori,Y, AU - Satomura,K, AU - Tobe,T, PY - 1989/12/1/pubmed PY - 1989/12/1/medline PY - 1989/12/1/entrez SP - 710 EP - 8 JF - Annals of surgery JO - Ann Surg VL - 210 IS - 6 N2 - Recently a number of surgeons have recommended radical resection of gastrinomas in Zollinger-Ellison syndrome (ZES). We have developed a useful technique for preoperative localization of gastrinomas--the selective arterial secretin injection test (SASI)--and we recommend an intraoperative secretin test (IOS) for deciding the radicality of resection of gastrinomas. Here the results of SASI and IOS tests in 11 patients with ZES are examined and compared with the results of other techniques. The SASI test localized gastrinomas in all of the patients, while the sensitivity of ultrasonography, computed tomography, arteriography, or portal venous blood samplings was between 1/11 and 5/11. On the basis of the results of the SASI test, radical resection of gastrinoma was performed in four patients (three pancreatoduodenectomies and one extirpation). After pancreatoduodenectomy, immunohistologic study of the specimen revealed multiple microgastrinomas and lymph node metastases in two patients and the coexistence of a microgastrinoma and a gastinoma in one patient. The IOS test was useful in the estimation of the advisability of radicality, and in two patients total gastrectomy was not performed because of the results of the IOS test. These four patients are well and have returned to work, and their serum gastrin levels are below 35 pg/mL. Thus we believe SASI and IOS tests are helpful for planning curative resection of gastrinomas. SN - 0003-4932 UR - https://www.unboundmedicine.com/medline/citation/2589884/Curative_resection_of_multiple_gastrinomas_aided_by_selective_arterial_secretin_injection_test_and_intraoperative_secretin_test_ L2 - https://Insights.ovid.com/pubmed?pmid=2589884 DB - PRIME DP - Unbound Medicine ER -