Tags

Type your tag names separated by a space and hit enter

Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome.
World J Surg. 1993 Jul-Aug; 17(4):455-62.WJ

Abstract

Studies have shown that the duodenum is a more common site (30-40%) of primary gastrinomas than previously reported. These tumors are often occult to conventional exploration, and their detection requires duodenotomy and meticulous evaluation of the mucosa by eversion and direct palpation. Furthermore, tumors as small as 1 to 2 mm may be associated with lymph node metastases. Seven patients with duodenal gastrinomas treated during a 2-year period are reported. Four had sporadic Zollinger-Ellison syndrome (ZES), and three had multiple endocrine neoplasia type I (MEN-I) syndrome. All seven patients had malignant duodenal gastrinomas as proved by metastatic lymph nodes and in one case a large liver metastasis as well. Local excision of the tumor, lymph node excisions, and in one case liver lobectomy resulted in eugastrinemia in the 4 with sporadic ZES. Two of the three with MEN-I were also eugastrinemic after similar procedures, with the addition of distal pancreatectomy. Duodenotomy is considered an essential procedure in sporadic ZES patients when no pancreatic tumor is found and in all MEN-I/ZES patients, regardless of the pancreatic findings. Regional lymph node excisions are essential when a duodenal tumor has been found.

Authors+Show Affiliations

Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0331.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

8103249

Citation

Thompson, N W., et al. "Duodenal Gastrinomas, Duodenotomy, and Duodenal Exploration in the Surgical Management of Zollinger-Ellison Syndrome." World Journal of Surgery, vol. 17, no. 4, 1993, pp. 455-62.
Thompson NW, Pasieka J, Fukuuchi A. Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome. World J Surg. 1993;17(4):455-62.
Thompson, N. W., Pasieka, J., & Fukuuchi, A. (1993). Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome. World Journal of Surgery, 17(4), 455-62.
Thompson NW, Pasieka J, Fukuuchi A. Duodenal Gastrinomas, Duodenotomy, and Duodenal Exploration in the Surgical Management of Zollinger-Ellison Syndrome. World J Surg. 1993 Jul-Aug;17(4):455-62. PubMed PMID: 8103249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Duodenal gastrinomas, duodenotomy, and duodenal exploration in the surgical management of Zollinger-Ellison syndrome. AU - Thompson,N W, AU - Pasieka,J, AU - Fukuuchi,A, PY - 1993/7/1/pubmed PY - 1993/7/1/medline PY - 1993/7/1/entrez SP - 455 EP - 62 JF - World journal of surgery JO - World J Surg VL - 17 IS - 4 N2 - Studies have shown that the duodenum is a more common site (30-40%) of primary gastrinomas than previously reported. These tumors are often occult to conventional exploration, and their detection requires duodenotomy and meticulous evaluation of the mucosa by eversion and direct palpation. Furthermore, tumors as small as 1 to 2 mm may be associated with lymph node metastases. Seven patients with duodenal gastrinomas treated during a 2-year period are reported. Four had sporadic Zollinger-Ellison syndrome (ZES), and three had multiple endocrine neoplasia type I (MEN-I) syndrome. All seven patients had malignant duodenal gastrinomas as proved by metastatic lymph nodes and in one case a large liver metastasis as well. Local excision of the tumor, lymph node excisions, and in one case liver lobectomy resulted in eugastrinemia in the 4 with sporadic ZES. Two of the three with MEN-I were also eugastrinemic after similar procedures, with the addition of distal pancreatectomy. Duodenotomy is considered an essential procedure in sporadic ZES patients when no pancreatic tumor is found and in all MEN-I/ZES patients, regardless of the pancreatic findings. Regional lymph node excisions are essential when a duodenal tumor has been found. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/8103249/Duodenal_gastrinomas_duodenotomy_and_duodenal_exploration_in_the_surgical_management_of_Zollinger_Ellison_syndrome_ L2 - http://www.diseaseinfosearch.org/result/7600 DB - PRIME DP - Unbound Medicine ER -