Zollinger- Ellison Syndrome may be surgically treated by: (AIIMS Nov 2010)
|A||Vagotomy and gastrojejunostomy|
|D||Vagotomy and partial gastrectomy|
a. Five-year survival in patients presenting with metastatic disease is approximately 40%.
b. All patients with sporadic (nonfamilial) gastrinoma should be considered for surgical resection and possible cure.
c. The lesions should be located in 90% of patients, and 60% are cured by extirpation of the gastrinoma(s).
d. A thorough intraoperative exploration of the gastrinoma triangle and pancreas is essential, but other sites (i.e., liver, stomach, small bowel, mesentery, and pelvis) should be evaluated as part of a thorough intra-abdominal evaluation to find the primary tumor, which is usually solitary.
e. The duodenum and pancreas should be extensively mobilized and intraoperative ultrasound should be used. Intraoperative EGD with transillumination should be considered.
f. If the tumor cannot be located, generous longitudinal duodenotomy with inspection and palpation should be considered.
g. Lymph nodes from the portal, peripancreatic, and celiac drainage basins should be sampled.