Abstract
Over a period of 21 years 39 patients with gastrinoma were surgically treated. Thirty-three patients had total gastrectomy with two postoperative deaths, and 6 patients had a lesser procedure. The postoperative fasting gastrin levels remained elevated and did not always indicate the extent of tumor involvement. Further mobilization of tumor gastrin by provocative infusion of calcium gluceptate, 15 mg/kg of body weight, should be carried out routinely. A hepatic angiogram should be considered when the gastrin levels exceed 1,000 picograms per ml. Chemotherapy consisting of Tubercidin, Streptozotocin and 5-Fluorouracil was given to 5 patients with extensive gastrinoma. All patients felt better and gained from three to 35 pounds in weight. Since 60% of the patients died or have definite evidence of tumor activity it is assumed that the tumor growth was not inhibited and that it is malignant. Approximately 40% of the patients seem to do well despite modest elevations in gastrin levels suggesting that the retained tumor could be considered benign.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- 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]
- Isenberg J. I., Walsh J. H., Passaro E., Jr, Moore E. W., Grossman M. I. Unusual effect of secretin on serum gastrin, serum calcium, and gastric acid secretion in a patient with suspected Zollinger-Ellison syndrome. Gastroenterology. 1972 Apr;62(4):626–631. [PubMed] [Google Scholar]
- Kahn C. R., Levy A. G., Gardner J. D., Miller J. V., Gorden P., Schein P. S. Pancreatic cholera: benefical effects of treatment with streptozotocin. N Engl J Med. 1975 May 1;292(18):941–945. doi: 10.1056/NEJM197505012921803. [DOI] [PubMed] [Google Scholar]
- Murray-Lyon I. M., Eddleston A. L., Williams R., Brown M., Hogbin B. M., Bennett A., Edwards J. C., Taylor K. W. Treatment of multiple-hormone-producing malignant islet-cell tumour with streptozotocin. Lancet. 1968 Oct 26;2(7574):895–898. doi: 10.1016/s0140-6736(68)91058-1. [DOI] [PubMed] [Google Scholar]
- Passaro E., Jr, Basso N., Sanchez R. E., Gordon H. E. New studies in the Zollinger-Ellison syndrome. Am J Surg. 1970 Aug;120(2):138–143. doi: 10.1016/s0002-9610(70)80101-5. [DOI] [PubMed] [Google Scholar]
- Sadoff L., Franklin D. Letter: Streptozotocin in the Zollinger-Ellison syndrome. Lancet. 1975 Sep 13;2(7933):504–505. doi: 10.1016/s0140-6736(75)90580-2. [DOI] [PubMed] [Google Scholar]
- Sanzenbacher L. J., King D. R., Zollinger R. M. Prognostic implications of calcium-mediated gastrin levels in the ulcerogenic syndrome. Am J Surg. 1973 Jan;125(1):116–121. doi: 10.1016/0002-9610(73)90015-9. [DOI] [PubMed] [Google Scholar]
- Siegel S. R., Muggia F. M. Letter: Treatment of "pancreatic cholera". N Engl J Med. 1975 Jul 24;293(4):198–198. doi: 10.1056/NEJM197507242930414. [DOI] [PubMed] [Google Scholar]
- Thompson J. C., Reeder D. D., Bunchman H. H., Becker H. D., Brandt E. N., Jr Effect of secretin on circulating gastrin. Ann Surg. 1972 Sep;176(3):384–393. doi: 10.1097/00000658-197209000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson J. C., Reeder D. D., Villar H. V., Fender H. R. Natural history and experience with diagnosis and treatment of the Zollinger-Ellison syndrome. Surg Gynecol Obstet. 1975 May;140(5):721–739. [PubMed] [Google Scholar]
- 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]