SURGICAL-TREATMENT OF THE ZOLLINGER-ELLISON SYNDROME

A consecutive series of patients with Zollinger-Ellison syndrome (ZES) is reported. A total of 53 cases were diagnosed, treated, and followe d by one department during the period 1971-1990. Curative surgery was considered in all cases after suppression of acid secretion and after localization of the tumors. Exploratory laparotomy was not employed. O f the 53 patients 13 (24%) died from metastatic gastrinoma during the study. Tumors were ultimately located in 31 of the patients, and 21 of these patients were operated. A total of 12 patients (21%) were cured . The best results were obtained after Whipple pancreaticoduodenectomy in patients with small tumors located after percutaneous transhepatic portography with blood sampling for gastrin assay. In this group 9 of 10 operated patients were cured. Multiple endocrine neoplasia type I did not seem to preclude curative resection. The findings support an a ggressive attitude toward local diagnosis and surgical treatment in ZE S patients, but they also stress the need for improvements in methods for localizing tumors.