Original Paper

Achieving Eugastrinaemia in Zollinger-Ellison Syndrome: Resection or Enucleation?
P.A. Thodiyil, N.S. El-Masry, R.C.N. Williamson

Department of Surgery, Hammersmith Hospital, London, UK

Address of Corresponding Author

Dig Surg 2001;18:118-123 (DOI: 10.1159/000050111)

  Key Words

• Gastrinoma
• Pancreas
• Ulceration

  Abstract

Background: Eugastrinaemia in Zollinger-Ellison syndrome can be an elusive goal, nearly one third of laparotomies failing to detect the tumour. Methods: A personal series of 13 patients with a mean age of 52 years operated between 1980 and 1996 was reviewed retrospectively. All patients had fasting hypergastrinaemia and recalcitrant ulcer disease with or without diarrhoea. Results: Computed tomography or selective visceral angiography localised the tumour to the pancreas in 6 of 12 elective patients; the thirteenth presented with a perforated duodenal ulcer. All underwent laparotomy with gastrinoma tissue being completely excised in every case, including the 6 patients with failed pre-operative localisation whose tumours arose from the duodenum (4), pancreas (1) and lymph node (1). Eugastrinaemia was achieved in all but 1 patient and was sustained during a mean follow-up of 5.2 years (SD = 4.2 years). These 12 patients remained clinically free of disease during a mean clinical follow-up of 7.5 years (SD = 5.0 years; range 2-19 years). There were no postoperative deaths, but 3 died from recurrent tumour at 3-7 years. Conclusion: Since normalisation of serum gastrin was achieved in 12 of 13 patients, laparotomy may well be worthwhile even if the gastrinoma cannot be localised pre-opera- tively.

Copyright © 2001 S. Karger AG, Basel

  Author Contacts

Prof. R.C.N. Williamson
Department of Surgery, Hammersmith Hospital
Du Cane Road, London W12 0NN (UK)
Tel. +44 208 383 3210, Fax +44 208 383 3023
E-Mail rcwillia@ic.ac.uk

  Article Information

Received: Received: October 13, 2000
Accepted: January 24, 2001
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 19