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The Zollinger‐Ellison syndrome: Review of recent progress in diagnosis and treatment
Author(s) -
Imamura Masayuki,
Hosotani Ryo,
Shimada Yutaka
Publication year - 1996
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf01212777
Subject(s) - zollinger ellison syndrome , medicine , gastrinoma , general surgery , gastroenterology , secretion , gastrin
Since the Zollinger-Ellison (Z-E) syndrome first appeared in the literature in a 1955 report of two patients, methods of treating this syndrome have undergone several changes? ,2 Based on having extracted gastrin from a pancreatic tumor, Gregory et al? attribute the cause of this syndrome to a pancreatic tumor, a gastrinoma that continuously produces and secretes gastrin. Radioimmunoassay of the patient's serum gastrin concentration enables early diagnosis. 4,5 For the first 10 years after the description of the Z-E syndrome, total gastrectomy was the most useful method for treating patients suffering from complications due to multiple recurring peptic ulcers. When the H2 blocker appeared, some doctors recommended the use of this drug as a nonsurgical treatment. 6 However, this therapeutic method was abandoned as the progressively growing, metastatic character of the gastrinoma became more widely known, and, with the introduction in 1985 of surgery as a method of treatment, the cure rate has greatly increased. Surgery still remains the preferred treatment modality, provided that no hematogenous metastasis has occurred. 7-1~ Recent improvements in determining the localization of gastrinomas has made curative resection possible, ~1 14 and whether the resection has been curative is easily ascertained by intraoperative secretin test, in which the serum gastrin concentration is soon evaluated by rapid radioimmunoassay. 8,11,~2