Zusammenfassung
Die aktuelle chirurgische Therapie des sporadischen Gastrinoms wird durch moderne präoperative Lokalisationsdiagnostika verbessert. Hochauflösender endsokopischer Ultraschall, szintigraphische und interventionelle radiologische Stufenkatheteruntersuchungen ermöglichen ein gezieltes chirurgisches Vorgehen. Die endoskopische Transillumination und Bestimmung des stimulierten Gastrins unterstützen die intraoperative Erfolgskontrolle.
Summary
Surgical therapy for sporadic gastrinoma profits from innovative pre- and intraoperative diagnostics. Preoperative gastrinoma localization is enhanced by sophisticated endoscopic ultrasonography, scintigraphic and arteriographic studies with hormon sampling. Thereby a concise surgical approach is guided and additional intraoperative control of success may be gained by endoscopic transillumination and measurement of stimulated gastrin levels.
References
Roy P, Venzon DJ, Shojamesh H, et al (2000) Zollinger-Ellison syndrome: clinical presentation in 261 cases. Medicine 79: 379–411
Zollinger RM (1984) Treatment of gastrinoma. Mount Sinai J Med 51: 401–403
Doppman JL (1992) Pancreatic endocrine tumors – the search goes on. N Engl J Med 326: 1770–1772
Thompson NW, Vinik AI, Eckhauser FE (1989) Microgastrinoma of the duodenum a cause of failed operations for the Zollinger-Ellison syndrome. Ann Surg 209: 396–404
Jensen RT (2001) Zollinger-Ellison syndrome. In: Doherty GM, Skogseid B (eds) Surgical endocrinology. Lippincott Williams & Wilkins, Philadelphia, pp 291–343
Pipeleers-Marichal M, Donow C, Heitz PU, Klöppel G (1993) Pathological aspects of gastrinoma in patients with Zollinger-Ellison syndrome with and without multiple endocrine neoplasia type 1. World J Surg 17: 481–488
Perrier ND, Batts KP, Thompson GB, Grant CS, Plummer TB (1995) An immunohistochemical survey for neuroendocrine cells in regional pancreatic lymph nodes: a plausible explanation for primary nodal gastrinomas? Surgery 118: 957–966
Norton JA, Alexander R, Fraker DL, Venzon DJ, Gibril F, Jensen RT (2003) Possible primary lymph node gastrinoma: Occurrence, natural history, and predictive factors. Ann Surg 237: 650–659
Imamura M, Takashi K, Adachi H, et al (1987) The usefulness of selective arterial secretin injection test for localization of gastrinoma in Zollinger-Ellison syndrome. Ann Surg 205: 230–239
Imamura M, Takashi K, Isobe Y (1989) Curative resection of multiple gastrinomas aided by selective arterial secretin injection test and intraoperative secretin test. Ann Surg 210: 710–718
Plockinger U, Wiedenmann X (2002) Neuroendocrine tumors of the gastro-entero-pancreatic system: the role of early diagnosis, genetic testing and preventive surgery. Dig Dis 20: 49–60
Krenning EP, Kwekkeboom DJ, Oei HY (1994) Somatostatin receptor scintigraphy in gastropancreatic tumors. Ann N Y Acad Sci 733: 416–424
Imamura M, Adachi H, Takashi K, et al (1982) Gastrin release from gastronoma cells stimulated with secretin. Dig Dis Sci 27: 1130–1136
Doppman JL, Miller DL, Chang R, et al (1990) Gastrinomas: localization by means of selective arterial injection of secretin. Radiology 174: 25–29
Wada M, Komoto I, Doi R, et al (2002) Intravenous calcium injection test is a novel complementary procedure in differential diagnosis for gastrinoma. World J Surg 26: 1291–1299
Gibril F, Doppman JL, Chang R, Weber HC, Termanini B, Jensen RT (1996) Metastatic gastrinomas: localization with selective arterial injection of secretin. Radiology 198: 7–84
Imamura M, Komoto I, Ota S (2006) Changing treatment strategy for gastrinoma in patients with Zollinger-Ellison syndrome. World J Surg 30: 1–11
Norton JA, Doppman JL, Jensen RT, et al (1999) Surgery to cure the Zollinger-Ellison syndrome. N Engl J Med 341: 635–644
Weber HC, Venzon DJ, Lin JT (1995) Determinants of metastatic rate and survival in patients with Zollinger-Ellison syndrome: a prospective long-term study. Gastroenterology 108: 1637–1649
Yu F, Venzon DJ, Serrano J, et al (1999) Prospective study of the clinical course, prognostic features and survival in patients with longstanding Zollinger-Ellison syndrome. J Clin Oncol 17: 615–630
Stabile BE, Passaro E Jr (1985) Benign and malignant gastronoma. Am J Surg 49: 144–150
Thom AK, Norton JA, Axiotis CA, et al (1991) Location, incidence and malignant potential of duodenal gastrinomas. Surgery 110: 1086–1093
Norton JA, Alexander R, Fraker DL, Venzon DJ, Gibril F, Jensen RT (2004) Does the use of routine duodenotomy (DUODX) affect rate of cure, development of liver metastases, or survival in patients with Zollinger-Ellison syndrome? Ann Surg 239: 617–626
Imamura M, Takashi K (1993) Use of selective arterial secretin injection test to guide surgery in patients with Zollinger-Ellison syndrome. World J Surg 17: 433–438
Kato M, Imamura M, Hosotani R, et al (2000) Curative resection of microgastrinomas based on the intraoperative secretin test. World J Surg 24: 1425–1430
Imamura M (1999) Establishment of a new strategy for gastrinomas based on the basic research on endocrine tumors. Formosan J Surg 32: 197–201
Jensen RT (1996) Should the 1996 citation for Zollinger-Ellison syndrome read: "acid-reducing surgery in, aggressive resections out"? Am J Gastroenerol 91: 1067–1070
Gilhool WJ (1984) Endoscopic diagnosis and removal of a duodenal wall gastrinoma. Am J Gastroenterol 79: 679–684
Straus E, Raufman JP, Samuel S, et al (1992) Endoscopic cure of the Zollinger-Ellison syndrome. Gastrointest Endosc 38: 709–711
Fernandez-Cruz L, Saenz A, Astudillo E, et al (2002) Outcome of laparoscopic pancreatic surgery: endocrine and nonendocrine tumors. World J Surg 26: 1057–1065
Jaskowiak NT, Fraker DL, Alexander HR, et al (1996) Is reoperation for gastrinoma excison in Zollinger-Ellison syndrome (ZES) indicated? Surgery 120: 105
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Lorenz, K., Dralle, H. Surgical treatment of sporadic gastrinoma. Wien Klin Wochenschr 119, 597–601 (2007). https://doi.org/10.1007/s00508-007-0882-4
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DOI: https://doi.org/10.1007/s00508-007-0882-4