Anti-ulcer drugs and hypergastrinism: utilization in surgery

The peptic ulcer disease associated with hypergastrinemia is very often a challenging problem of diagnosis and therapy. In absolute surgical emergency (haemorrhagic and perforative complications), the utilization of the most recently discovered anti-ulcer drugs appears to be extremely helpful; the prevention of incumbent complications can be accomplished, in fact, during the post-operative treatment and the "free time" so obtained can be used for an adequate differential diagnosis (gastrinoma-induced Zollinger-Ellison syndrome: antrum retained, G cells of the antrum hyperplastic, apud-tumours with hypersecretion). The "anti-H2 and anti-muscarinic" drugs (often in association) give the surgeon the possibility of an accurate diagnosis and the choice of the best surgical procedure (tumorectomy, DCP, gastrectomy). Even in elective surgery the prevention with anti-H2 drugs permits greater "safety margins" and an optimal follow-up study. The results of the surgical experience in the General Surgical Clinic of Pisa (18 cases of Z.E.'s) confirm the validity of the associated anti-ulcer therapy.