We have located links that may give you full text access.
Extrapancreatic gastrinomas. Surgical experience.
Archives of Surgery 1994 May
OBJECTIVE: Although widely reported on, the clinical diversity and eventual varied outcome of patients with extrapancreatic gastrinomas remain a medical mystery. In an attempt to help clarify conflicting management of extrapancreatic gastrinomas, we reviewed our experience with these unique tumors.
DESIGN: Retrospective analysis with long-term follow-up (mean, 8 years).
SETTING: Tertiary care referral center.
PATIENTS: From January 1958 through January 1993, we identified and operated on 23 patients with extrapancreatic gastrinomas (duodenum, n = 18; stomach, n = 3; nodal, n = 2). The 12 men and 11 women (none with multiple endocrine neoplasia type I syndrome) ranged in age from 12 to 68 years (mean, 47 years). Preoperatively, all patients were symptomatic with peptic ulcer disease (duodenal [n = 18, 78%], jejunal [n = 4, 17%]) and/or diarrhea (n = 17, 74%).
INTERVENTION: Preoperatively, tumor localization was successful in only three patients (13%). Surgical management included tumor excision only in 14 patients (61%), partial gastroduodenectomy in six (27%), total gastrectomy in one (4%), limited enterectomy in one (4%), and tumor biopsy alone in one (4%). Seven patients had evidence of lymphatic metastases at the time of operation, including a single patient with hepatic metastases (malignancy rate, 30%). Postoperatively, complications developed in seven patients (30%): wound infection in two, ileus in two, pulmonary sepsis in one, intra-abdominal abscess in one, and diabetic ketoacidosis in one. The postoperative mortality rate was 4%.
MAIN OUTCOME MEASURE: Emphasis was placed on rendering patients eugastrinemic.
RESULTS: Long-term follow-up (mean, 8 years) of all patients revealed that 11 patients (48%) were eugastrinemic, asymptomatic, and not receiving gastric acid-reducing medication. Sixteen patients remain alive and well. Of the six now decreased patients who had been participating in long-term follow-up (mean survival, 14 years), death was due to atherosclerotic coronary artery disease in four and tumor progression in two.
CONCLUSION: Following surgical excision, patients with extrapancreatic gastrinomas have a favorable outcome, with nearly half being cured.
DESIGN: Retrospective analysis with long-term follow-up (mean, 8 years).
SETTING: Tertiary care referral center.
PATIENTS: From January 1958 through January 1993, we identified and operated on 23 patients with extrapancreatic gastrinomas (duodenum, n = 18; stomach, n = 3; nodal, n = 2). The 12 men and 11 women (none with multiple endocrine neoplasia type I syndrome) ranged in age from 12 to 68 years (mean, 47 years). Preoperatively, all patients were symptomatic with peptic ulcer disease (duodenal [n = 18, 78%], jejunal [n = 4, 17%]) and/or diarrhea (n = 17, 74%).
INTERVENTION: Preoperatively, tumor localization was successful in only three patients (13%). Surgical management included tumor excision only in 14 patients (61%), partial gastroduodenectomy in six (27%), total gastrectomy in one (4%), limited enterectomy in one (4%), and tumor biopsy alone in one (4%). Seven patients had evidence of lymphatic metastases at the time of operation, including a single patient with hepatic metastases (malignancy rate, 30%). Postoperatively, complications developed in seven patients (30%): wound infection in two, ileus in two, pulmonary sepsis in one, intra-abdominal abscess in one, and diabetic ketoacidosis in one. The postoperative mortality rate was 4%.
MAIN OUTCOME MEASURE: Emphasis was placed on rendering patients eugastrinemic.
RESULTS: Long-term follow-up (mean, 8 years) of all patients revealed that 11 patients (48%) were eugastrinemic, asymptomatic, and not receiving gastric acid-reducing medication. Sixteen patients remain alive and well. Of the six now decreased patients who had been participating in long-term follow-up (mean survival, 14 years), death was due to atherosclerotic coronary artery disease in four and tumor progression in two.
CONCLUSION: Following surgical excision, patients with extrapancreatic gastrinomas have a favorable outcome, with nearly half being cured.
Full text links
Related Resources
Trending Papers
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices 
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app