title: Resection of gastrinoma in the Zollinger-Ellison syndrome.
abstract: Patients with the Zollinger-Ellison syndrome have been managed by total gastrectomy and more recently, by the use of H2-receptor antagonists. An alternative approach has been to identify those who might be cured by excision of a pancreatic islet-cell tumor without removal of the stomach. The course of such a patient is reported. A 40-yr-old man with massive gastric hypersecretion, acid-peptic disease, diarrhea, and elevated serum gastrin was treated by excising a pancreatic gastrinoma. Serum gastrin and gastric secretion became and have remained normal for 7 yr. Symptoms ceased and provocative tests with secretin and calcium have remained normal. Three additional patients with Zollinger-Ellison syndrome in whom pancreatic islet-cell tumor resection alone has resulted in long-term cures have been identified. All were middle-aged men with severe diarrhea. These successes, the availability of techniques that permit early identification and localization of gastrinomas, and the advent of H2-receptor antagonists that can control gastric hypersecretion without gastrectomy must be considered in managing patients with gastrinomas.
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D005743:Gastrectomy; D005755:Gastrins / Q000097:blood; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery*; D015043:Zollinger-Ellison Syndrome / Q000601:surgery*
chemical_list: D005755:Gastrins