Norton JA, Jensen RT. Resolved and unresolved controversies in the surgical management of patients with Zollinger-Ellison syndrome.
Ann Surg 2004;
240:757-73. [PMID:
15492556 PMCID:
PMC1356480 DOI:
10.1097/01.sla.0000143252.02142.3e]
[Citation(s) in RCA: 149] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE
Highlight unresolved controversies in the management of Zollinger-Ellison syndrome (ZES).
SUMMARY BACKGROUND DATA
Recent studies have resolved some of the previous controversies including the surgical cure rate in patients with and without Multiple Endocrine Neoplasia-type1 (MEN1), the biological behavior of duodenal and pancreatic gastrinomas, role of imaging studies to localize tumor, and gastrectomy to manage acid output.
METHODS
Review of the literature based on computer searches in Index Medicus, Pubmed and Ovid.
RESULTS
Current controversies as identified in the literature include the role of endoscopic ultrasound (EUS), surgery in ZES patients with MEN1, pancreaticoduodenectomy (Whipple procedure), lymph node primary gastrinoma, parietal cell vagotomy, reoperation and surgery for metastatic tumor, and the use of minimally invasive surgical techniques to localize and remove gastrinoma.
CONCLUSIONS
It is hoped that future studies will focus on these issues to improve the surgical management of ZES patients.
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