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Effect of vagotomy in Zollinger-Ellison syndrome.
Gastroenterology. 1979 Oct; 77(4 Pt 1):682-6.G

Abstract

We evaluated the effect of vagotomy on gastric acid secretion and the clinical course in 3 patients with Zollinger-Ellison syndrome. Basal acid hypersecretion was reduced by 49, 86, and 96%, and peak acid output in response to pentagastrin was reduced by 36, 39, and 71% in the 3 patients. In one patient, 300 mg cimetidine reduced basal acid secretion from 65 to 20 meq/hr before vagotomy; whereas after vagotomy basal acid secretion was reduced from 36 to 0.6 meq/hr by the same dose of cimetidine. One patient has required no antisecretory therapy for 14 yr, whereas 2 patients have also been treated with cimetidine with excellent results. We conclude that vagotomy facilitates control of acid secretion in Zollinger-Ellison syndrome, and we recommend vagotomy and cimetidine rather than total gastrectomy or cimetidine alone for the management of these patients. This combined surgical and medical approach should also allow discovery and removal of isolated tumors in about 10% of patients.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

467924

Citation

Richardson, C T., et al. "Effect of Vagotomy in Zollinger-Ellison Syndrome." Gastroenterology, vol. 77, no. 4 Pt 1, 1979, pp. 682-6.
Richardson CT, Feldman M, McClelland RN, et al. Effect of vagotomy in Zollinger-Ellison syndrome. Gastroenterology. 1979;77(4 Pt 1):682-6.
Richardson, C. T., Feldman, M., McClelland, R. N., Dickerman, R. M., Kumpuris, D., & Fordtran, J. S. (1979). Effect of vagotomy in Zollinger-Ellison syndrome. Gastroenterology, 77(4 Pt 1), 682-6.
Richardson CT, et al. Effect of Vagotomy in Zollinger-Ellison Syndrome. Gastroenterology. 1979;77(4 Pt 1):682-6. PubMed PMID: 467924.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of vagotomy in Zollinger-Ellison syndrome. AU - Richardson,C T, AU - Feldman,M, AU - McClelland,R N, AU - Dickerman,R M, AU - Kumpuris,D, AU - Fordtran,J S, PY - 1979/10/1/pubmed PY - 1979/10/1/medline PY - 1979/10/1/entrez SP - 682 EP - 6 JF - Gastroenterology JO - Gastroenterology VL - 77 IS - 4 Pt 1 N2 - We evaluated the effect of vagotomy on gastric acid secretion and the clinical course in 3 patients with Zollinger-Ellison syndrome. Basal acid hypersecretion was reduced by 49, 86, and 96%, and peak acid output in response to pentagastrin was reduced by 36, 39, and 71% in the 3 patients. In one patient, 300 mg cimetidine reduced basal acid secretion from 65 to 20 meq/hr before vagotomy; whereas after vagotomy basal acid secretion was reduced from 36 to 0.6 meq/hr by the same dose of cimetidine. One patient has required no antisecretory therapy for 14 yr, whereas 2 patients have also been treated with cimetidine with excellent results. We conclude that vagotomy facilitates control of acid secretion in Zollinger-Ellison syndrome, and we recommend vagotomy and cimetidine rather than total gastrectomy or cimetidine alone for the management of these patients. This combined surgical and medical approach should also allow discovery and removal of isolated tumors in about 10% of patients. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/467924/Effect_of_vagotomy_in_Zollinger_Ellison_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016508579001967 DB - PRIME DP - Unbound Medicine ER -