Effect of vagotomy in Zollinger-Ellison syndrome

Charles T. Richardson, Mark Feldman, Robert N. McClelland, Richard M. Dickerman, Dean Kumpuris, John S. Fordtran

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Abstract

We evaluated the effect of vagotomy on gastric acid secretion and the clinical course in 3 patients with Zollinger-Ellison syndrome. Basal acid hypersecretion was reduced by 49, 86, and 96%, and peak acid output in response to pentagastrin was reduced by 36, 39, and 71% in the 3 patients. In one patient, 300 mg cimetidine reduced basal acid secretion from 65 to 20 meq/hr before vagotomy; whereas after vagotomy basal acid secretion was reduced from 36 to 0.6 meq/hr by the same dose of cimetidine. One patient has required no antisecretory therapy for 14 yr, whereas 2 patients have also been treated with cimetidine with excellent results. We conclude that vagotomy facilitates control of acid secretion in Zollinger-Ellison syndrome, and we recommend vagotomy and cimetidine rather than total gastrectomy or cimetidine alone for the management of these patients. This combined surgical and medical approach should also allow discovery and removal of isolated tumors in about 10% of patients.

Original languageEnglish (US)
Pages (from-to)682-686
Number of pages5
JournalGastroenterology
Volume77
Issue number4
StatePublished - Oct 1979

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Richardson, C. T., Feldman, M., McClelland, R. N., Dickerman, R. M., Kumpuris, D., & Fordtran, J. S. (1979). Effect of vagotomy in Zollinger-Ellison syndrome. Gastroenterology, 77(4), 682-686.