Conservative surgery in Zollinger-Ellison syndrome: report of a case with an eight-year follow-up.
The patient described here, with malignant non-beta islet cell tumor of the head of the pancreas, was treated by resection of the tumor and metastases. Additional pathology of perforated duodenal ulcer and pyloric stenosis required vagotomy and pyloroplasty. The maintenance of normal gastrin levels after the operation indicates a good prognosis. We believe that the low-risk Zollinger-Ellison patient should be treated surgically and the tumor removed. When no tumor can be detected, parietal cell vagotomy should be performed to assist the pharmacological control of the gastric acid hypersecretion. Extensive surgery, such as total gastrectomy, is no longer the treatment of choice and is reserved for the so-called "cimetidine failure."
D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D010439:Peptic Ulcer Perforation / Q000473:pathology / Q000601:surgery; D011707:Pyloric Stenosis / Q000473:pathology / Q000601:surgery; D015043:Zollinger-Ellison Syndrome / Q000150:complications / Q000473:pathology / Q000601:surgery*