Role of selective arterial secretin injection test in treatment of gastrinoma.

BACKGROUND/AIMS: To study whether use of the selective arterial secretin injection test increased the rate of tumor localization and curative resection in patients with gastrinoma.

METHODOLOGY

Nine patients with gastrinoma were divided into 2 groups, before and after introduction of selective arterial secretin injection test; 4 patients before 1987 (Group 1) and 5 patients after 1988 (Group 2). Clinical results were compared retrospectively between groups.

RESULTS

Localization of primary gastrinoma was made with conventional imaging studies in 1 of the 4 patients in Group 1 and 3 of the 5 patients in Group 2. In contrast, use of the selective arterial secretin injection test was able to localize the primary tumor in 4 of the 5 patients in Group 2. Total gastrectomy was carried out in the 4 patients in Group 1, and pancreatoduodenectomy was the most frequently performed procedure (3 patients) in Group 2. Rate of curative resection was 25% and 80% in Groups 1 and 2, respectively.

CONCLUSIONS

These results indicate that combining selective arterial secretin injection test with conventional imaging studies contributes to increasing rate of curative resection of gastrinoma.