Dc. Metz et al., CONTROL OF GASTRIC-ACID HYPERSECRETION IN THE MANAGEMENT OF PATIENTS WITH ZOLLINGER-ELLISON SYNDROME, World journal of surgery, 17(4), 1993, pp. 468-480
During the last 5 years important advances have occurred in the contro
l of gastric acid hypersecretion in Zollinger-Ellison syndrome (ZES).
The increased availability of potent gastric acid antisecretory agents
such as histamine H-2-receptor antagonists and more recently the H+K-ATPase inhibitors such as omeprazole and lansoprazole have made it po
ssible to medically control acid secretion in all patients. Increased
understanding of the variation in antisecretory drug dosage between in
dividual patients has led to identification of criteria to ensure effe
ctive antisecretory control and to the recognition of subgroups of pat
ients who require special monitoring. Effective regimens for parentera
l antisecretory control during surgery have been established. The impo
rtance of parathyroidectomy in patients with multiple endocrine neopla
sia type I with ZES and the possible usefulness of highly selective va
gotomy have been investigated. We review here the new data that led to
increased understanding in each of these areas from our studies and s
tudies by others.