TY - JOUR
T1 - Effect of vagotomy in Zollinger-Ellison syndrome
AU - Richardson, Charles T.
AU - Feldman, Mark
AU - McClelland, Robert N.
AU - Dickerman, Richard M.
AU - Kumpuris, Dean
AU - Fordtran, John S.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1979/10
Y1 - 1979/10
N2 - 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.
AB - 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.
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U2 - 10.1016/0016-5085(79)90221-x
DO - 10.1016/0016-5085(79)90221-x
M3 - Article
C2 - 467924
AN - SCOPUS:0018296591
SN - 0016-5085
VL - 77
SP - 682
EP - 686
JO - Gastroenterology
JF - Gastroenterology
IS - 4
ER -