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The management of Zollinger—Ellison syndrome
Author(s) -
MATON P. N.
Publication year - 1993
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.1993.tb00122.x
Subject(s) - gastrinoma , zollinger ellison syndrome , medicine , omeprazole , multiple endocrine neoplasia , gastroenterology , gastric acid , pancreas , surgery , stomach , gastrin , biochemistry , chemistry , secretion , gene
SUMMARY Awareness of the sometimes subtle features of Zollinger–Ellison syndrome is important in order not to miss the diagnosis. Immediately after initial diagnostic tests, the patient should be given antisecretory medication, while tests for the type of Zollinger–Ellison syndrome and tumour extent can be delayed. Acid output should be decreased to < 10 mmol/h to control symptoms and prevent complications. Histamine H 2 ‐ antagonists remain the best available intravenous therapy but omeprazole is the most effective long‐term oral therapy and has proved to be safe in nearly 10 years of continuous use. The management of the gastrinoma has changed in recent years since the discovery that the majority of gastrinomas arise outside the pancreas. Exploratory surgery with tumour resection is the treatment of choice in sporadic Zolliiger‐Ellison syndrome but there are few indications for surgery in patients with Zollinger–Ellison syndrome and multiple endocrine neoplasia type‐1. None of the available therapies for metastatic gastrinoma is very effective.