Standard procedure	Kocher maneuver to mobilize duodenum. Endoscopic transillumination of duodenum. Intraoperative ultrasonography. Manual palpation of pancreas and duodenum.
Contraindications	Widely metastatic disease (liver and bone). MEN I. Significant cardiopulmonary disease.
Complications	Pancreatic fistulas, bowel obstruction, pancreatitis, bowel leak, anastomotic ulcer.
Special points	Surgery should be performed by a surgeon with significant experience in intraoperative localization methods for islet cell tumors [33]. Perioperative gastric acid control is important for reducing the complications of gastric acid hypersecretion.
Cost effectiveness	The curative resection of gastrinoma tumors in nearly 60% of patients is significant for long-term prognosis of these patients [33]. Following curative gastrinoma resection, more than half of the patients will require long-term gastric acid secretory control because parietal cell mass remains increased despite curative resection [30,33].