Diagnosis and Surgical Treatment of Pancreatic Gastrinoma in 13 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Xiaoguang , LU Yunfu

Department of General Surgery， Hainan Provincial People’s Hospital， Haikou 570311， Hainan Province， China;

Corresponding author：

Keywords：

Pancreas; Gastrinoma; Diagnosis; Therapy

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Objective 　To investigate the diagnosis and treatment of pancreatic gastrinoma.
Methods 　The clinical data of 13 patients with pancreatic gastrinoma who were admitted to Hainan Provincial People’s Hospital from Jan. 1990 to Dec. 2010 were retrospectively analyzed. Etiologic and localization diagnosis were preformed preoperatively according to the manifestation and the results of color Doppler ultrasound and computer tomography，respectively. All patients received chemoradiotherapy after operation according to the pathology results.
Results 　All of the thirteen patients underwent operation. The location of pancreatic gastrinoma was found in the head of the pancreas in 9 cases，in the tail of the pancreas in 1 case，in the body of the pancreas in 2 cases， and 1 case with multiple pancreatic gastrinonma，respectively. The diameters of the pancreatic gastrinoma were 0.2-4.0cm and 11 patiens were above 2.0cm. One patient underwent resection of the body and tail of the pancreas and spleen，seven patients underwent tumor resection，two patients underwent resection of the choledocho-pancreatic junction， and three patients underwent pancreaticoduodenectomy. One patient complicated with pancreatic leakage and two with incision infection. Twelve patients were followed up for 16-120 months （mean 78 months）. Clinical symptoms such as diarrhea disappeared after operation in twelve patients. Results of electronic gastroscopy in 6 months after continuous treatment with proton pump inhibition agents showed that the gastric ulcer were healed，the 12 hour gastric juice volume and the level of the gastric acid were in the normal range. Ten patients were cured，but one patient died because of other disease in 1 year after operation，one patient died because of recurrence in 1.5 years after operation， and one patient died in 4 years after reoperation of liver metastases.
Conclusion 　Surgical treatment is a effective method for pancreatic gastrinoma.

Citation： GONG Xiaoguang,LU Yunfu. Diagnosis and Surgical Treatment of Pancreatic Gastrinoma in 13 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(10): 1048-1051. doi: Copy

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1. Nieto JM， Pisegna JR. The role of proton pump inhibitors in the treatment of Zollinger-Ellison syndrome[J]. Expert Opin Pharmacother， 2006， 7(2)：169-175.
2. Hung PD， Schubert ML， Mihas AA， et al. Zollingerr-Ellisom syndrome[J]. Curr Treat Options Gastroenterol， 2003， 6(2)：163-170.
3. Fidler JL， Fletcher JG， Reading CC， et al. Preoperative detection of pancreatic insulinomas on multiphasic helical CT[J]. AJR Am J Rocntgenol， 2003， 181(3)：775-780.
4. Mirallié E， Pattou F， Malvaux P， et al. Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases[J]. Gastroenterol Clin Biol， 2002， 26(4)：360-366.
5. Rosch T， Lightdale CJ， Botet JF， et al. Localization of pancreaticendocrine tumors by endoscopic ultrasonography[J]. N Engl J Med， 1992， 326(26)：1721-1726.
6. Ku YM， Shin SS， Lee CH， et al. Magnetic resonance imaging of cystic and endocrine pancreatic neoplasms[J]. Top Magn Reson Imaging， 2009， 20(1)：11-18.
7. Proye C， Malvaux P， Pattou F， et al. Noninvasive imaging ofinsulinomas and gastrinomas with endoscopic ultrasonography and somatostatin receptor scintigraphy[J]. Surgery， 1998， 124(6)：1134-1143.
8. Won JG， Tseng HS， Yang AH， et al. Intra-arterial calcium stimulation test for detection of insulinomas：detection rate， responses of pancreatic peptides， and its relationship to differentiation of tumor cells[J]. Metabolism， 2003， 52(10)：1320-1329.
9. McAuley G， Delaney H， Colville J， et al. Multimodalitypreoperative imaging of pancreatic insulinomas[J]. Clin Radiol，.
10. Gibril F， Reynolds JC， Doppman JL， et al. Somatostatin receptorscintigraphy：its sensitivity compared with that of other imagingmethods in detecting primary and metastatic gastrinomas. Aprospective study[J]. Ann Intern Med， 1996， 125(1)：26-34.
11. Weber HC， Venzon DJ， Lin JT， et al. Determinants of metastatic rate and survival in patients with Zollinger-Ellison syndrome：a prospective long-term study[J]. Gastroenterology， 1995， 108(6)：1637-1649.
12. Chamberlain RS， Canes D， Brown KT， et al. Hepatic neuroendocrine metastases：does intervention alter outcomes?[J]. J Am Coll Surg， 2000， 190(4)：432-445.
13. ， 60(10)：1039-1050.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Surgical Treatment of Pancreatic Gastrinoma in 13 Cases

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