Laparotomy and proximal gastric vagotomy in Zollinger-Ellison syndrome: Results of a 16-year prospective study

Katherine E. McArthur, Charles T. Richardson, Cora C. Barnett, Nahid Eshaghi, Michael J. Smerud, Robert N. McClelland, Mark Feldman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective: Pharmacological control of gastric acid hypersecretion in the Zollinger-Ellison syndrome has steadily improved, but medical treatment does not address the underlying tumor. The objective of this study was to evaluate the long-term effectiveness of a surgical approach to both tumor and acid hypersecretion in 22 patients with the Zollinger-Ellison syndrome. Methods: Patients underwent laparotomy to resect tumors, combined with vagotomy to reduce acid secretion, followed by postoperative antisecretory therapy, if necessary. Results: No surgical mortality or serious morbidity occurred. Tumor was found at laparotomy in nine patients (41%) and during long-term follow-up in an additional two patients (9%). Ten-year survival is 81%, with a long-term cure rate of at least 14%. Most patients (86%) have had long- term inhibition of acid secretion. Eight patients have discontinued regular use of acid-inhibiting medications. Patients requiring medication need less of it, and they have an improved acid inhibitory response to medication for up to 16 yr after surgery. Conclusion: Cure of the Zollinger-Ellison syndrome is possible in a minority of patients. Acid secretion can be safely reduced in almost all patients with laparotomy/vagotomy, usually allowing discontinuation, or reduced dose, of acid-inhibiting drugs. Long-term survival and quality of life are generally excellent.

Original languageEnglish (US)
Pages (from-to)1104-1111
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume91
Issue number6
StatePublished - Jun 1 1996

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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