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Resection of gastrinomas.

C W Deveney, K E Deveney, D Stark

    Annals of Surgery
    |October 1, 1983
    PubMed
    Summary
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    Surgical resection offers a cure for some Zollinger-Ellison syndrome (ZES) patients with gastrinomas. Early detection and surgical intervention are key for improving outcomes in ZES management.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Endocrinology

    Background:

    • Zollinger-Ellison syndrome (ZES) is characterized by gastrin-producing tumors (gastrinomas).
    • Identifying and resecting these tumors is crucial for patient management.
    • Surgical outcomes and diagnostic advancements require evaluation.

    Purpose of the Study:

    • To assess the efficacy of exploratory laparotomy and gastrinoma resection in ZES patients.
    • To evaluate the role of CT scans in detecting gastrinomas preoperatively.
    • To determine optimal management strategies for resectable and unresectable gastrinomas.

    Main Methods:

    • Exploratory laparotomy and gastrinoma search in 52 ZES patients.
    • Surgical resection of identified gastrinomas.

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  • Correlation of CT scan findings with intraoperative discoveries.
  • Assessment of long-term outcomes, including cure rates and recurrence.

    • Main Results:

    • Gastrinoma resection was achieved in 21% of patients, with 12% achieving a cure.
    • Tumors were unresectable in 40% due to metastases and 40% due to inability to locate.
    • CT scans correlated with laparotomy findings in 13/16 patients; smallest detected tumor was 1 cm.
    • No deaths or serious complications occurred in surgical attempts over 10 years.

    Conclusions:

    • Surgical resection should be strongly considered for all ZES patients.
    • Advanced imaging like CT scans and invasive methods like portal venous sampling aid tumor localization.
    • Total gastrectomy remains a viable option for unresectable tumors, with minimal mortality.