Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1981 Dec;194(6):692–697. doi: 10.1097/00000658-198112000-00005

Results of surgical management in 92 consecutive patients with Zollinger-Ellison syndrome.

S Bonfils, J H Landor, M Mignon, P Hervoir
PMCID: PMC1345379  PMID: 7030236

Abstract

Hospital records and follow-up information on 92 patients with surgically proven Zollinger-Ellison syndrome have been reviewed, and data relating to symptomatology, age and sex incidence, pathologic findings, and early and late results of surgical procedures have been summarized. The postoperative mortality rate was 15%, and was adversely affected by previous peptic ulcer surgery, by the necessity of urgent operation for complications of peptic ulcer, and by employment of a procedure that failed to control acid secretion. Thirteen patients were found to have primary gastrinomas of the duodenum and an additional 13 patients had islet cell hyperplasia without evidence of frank neoplasm; prognosis in these two groups appears to be particularly favorable. Despite the current availability of effective nonoperative measures for control of gastric hypersecretion, surgical exploration is warranted in all patients to determine location and extent of tumor and to attempt to control the ulcer diathesis by resection of tumor. Long-term therapy with H2 receptor antagonists is advised for patients whose hypersecretory state has not been alleviated by tumor resection or whose gastrinoma cannot be removed. Total gastrectomy is still indicated in patients whose tumors are not amenable to resection and who are resistant to, or cannot follow, a rigid medical regimen.

Full text

PDF
696

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blair E. L., Grund E. R., Miller I. T., Redd J. D., Sanders D. J., Thompson M. H., Venables C. W. Metiamide in the Zollinger-Ellison syndrome. Am J Dig Dis. 1975 Dec;20(12):1123–1130. doi: 10.1007/BF01070755. [DOI] [PubMed] [Google Scholar]
  2. Bonfils S., Mignon M., Gratton J. Cimetidine treatment of acute and chronic Zollinger-Ellison syndrome. World J Surg. 1979 Sep 20;3(5):597–604. doi: 10.1007/BF01654767. [DOI] [PubMed] [Google Scholar]
  3. Bonfils S., Mignon M., Landor J. H. Management of Zollinger-Ellison syndrome. N Engl J Med. 1980 Oct 16;303(16):942–943. doi: 10.1056/NEJM198010163031618. [DOI] [PubMed] [Google Scholar]
  4. Creutzfeldt W., Arnold R., Creutzfeldt C., Track N. S. Pathomorphologic, biochemical, and diagnostic aspects of gastrinomas (Zollinger-Ellison syndrome). Hum Pathol. 1975 Jan;6(1):47–76. doi: 10.1016/s0046-8177(75)80109-2. [DOI] [PubMed] [Google Scholar]
  5. Deveney C. W., Deveney K. S., Way L. W. The Zollinger-Ellison syndrome--23 years later. Ann Surg. 1978 Sep;188(3):384–393. doi: 10.1097/00000658-197809000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dubrasquet M., Bonfils S., Bader J. P., Martin E., Sergent D. Essai biologique des urines (test PSU) pour le diagnostic et la surveillance postopératoire du syndrome de Zollinger-Ellison. Acta Gastroenterol Belg. 1973 Sep;36(9):438–448. [PubMed] [Google Scholar]
  7. ELLISON E. H., WILSON S. D. THE ZOLLINGER-ELLISON SYNDROME: RE-APPRAISAL AND EVALUATION OF 260 REGISTERED CASES. Ann Surg. 1964 Sep;160:512–530. doi: 10.1097/00000658-196409000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fox P. S., Hofmann J. W., Wilson S. D., DeCosse J. J. Surgical management of the Zollinger-Ellison syndrome. Surg Clin North Am. 1974 Apr;54(2):395–407. doi: 10.1016/s0039-6109(16)40287-2. [DOI] [PubMed] [Google Scholar]
  9. Friesen S. R. A gastric factor in the pathogenesis of the Zollinger-Ellison syndrome. Ann Surg. 1968 Sep;168(3):483–501. doi: 10.1097/00000658-196809000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Friesen S. R. Effect of total gastrectomy on the Zollinger-Ellison tumor: observations by second-look procedures. Surgery. 1967 Oct;62(4):609–613. [PubMed] [Google Scholar]
  11. Hofmann J. W., Fox P. S., Wilson S. D. Duodenal wall tumors and the Zollinger-Ellison syndrome. Surgical management. Arch Surg. 1973 Aug;107(2):334–339. doi: 10.1001/archsurg.1973.01350200194040. [DOI] [PubMed] [Google Scholar]
  12. Mainardi M., Maxwell V., Sturdevant R. A., Isenberg J. I. Inhibition of gastric acid secretion by metiamide in Zollinger-Ellison syndrome. Am J Dig Dis. 1975 Mar;20(3):280–281. doi: 10.1007/BF01070731. [DOI] [PubMed] [Google Scholar]
  13. McCarthy D. M. The place of surgery in the Zollinger-Ellison syndrome. N Engl J Med. 1980 Jun 12;302(24):1344–1347. doi: 10.1056/NEJM198006123022404. [DOI] [PubMed] [Google Scholar]
  14. Mignon M., Accary J. P., Bonfils S. Signification diagnostique du test à la sécrétine dans le syndrome de Zollinger-Ellison. Analyse statistique de la réponse gastrinique et acide dans une série de 21 tests positifs. Gastroenterol Clin Biol. 1977;1(5):425–434. [PubMed] [Google Scholar]
  15. Mignon M., Vallot T., Mayeur S., Bonfils S. Ranitidine and cimetidine in Zollinger-Ellison syndrome. Br J Clin Pharmacol. 1980 Aug;10(2):173–174. doi: 10.1111/j.1365-2125.1980.tb01738.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Oberhelman H. A., Jr Excisional therapy for ulcerogenic tumors of the duodenum: long-term results. Arch Surg. 1972 Apr;104(4):447–453. doi: 10.1001/archsurg.1972.04180040061011. [DOI] [PubMed] [Google Scholar]
  17. Richardson C. T., Feldman M., McClelland R. N., Dickerman R. M., Kumpuris D., Fordtran J. S. Effect of vagotomy in Zollinger-Ellison syndrome. Gastroenterology. 1979 Oct;77(4 Pt 1):682–686. [PubMed] [Google Scholar]
  18. Yalow R. S., Berson S. A. Radioimmunoassay of gastrin. Gastroenterology. 1970 Jan;58(1):1–14. [PubMed] [Google Scholar]
  19. ZOLLINGER R. M., ELLISON E. H. Primary peptic ulcerations of the jejunum associated with islet cell tumors of the pancreas. Ann Surg. 1955 Oct;142(4):709-23; discussion, 724-8. [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES