Fendrich V, Langer P, Waldmann J, Bartsch D K, Rothmund M
Department of Surgery, Philipps University Marburg, Marburg, Bielefeld, Germany.
Br J Surg. 2007 Nov;94(11):1331-41. doi: 10.1002/bjs.5987.
Gastrinomas are functional endocrine duodenopancreatic tumours and are responsible for Zollinger-Ellison syndrome (ZES). Clinical presentation, localization techniques and operative management were reviewed.
An electronic search of the Medline database was undertaken for articles published in English between January 1987 and May 2007. This timeframe was chosen because of the fundamental changes in operative strategy, antisecretory therapy and localization techniques during this period.
Most gastrinomas are located in the 'gastrinoma triangle', comprising the head of the pancreas, and the first and second parts of the duodenum. Some 20 per cent of gastrinomas occur in association with multiple endocrine neoplasia type 1 (MEN1) and 50-60 per cent of tumours are malignant at the time of diagnosis. Biochemical evidence justifies operation of which duodenotomy is an essential part. Only complete tumour resection allows 5- and 10-year survival rates of 90 per cent. Pylorus-preserving pancreaticoduodenectomy may be the procedure of choice for MEN1-ZES.
胃泌素瘤是功能性内分泌十二指肠胰腺肿瘤,可导致卓-艾综合征(ZES)。对其临床表现、定位技术及手术治疗进行综述。
对1987年1月至2007年5月期间发表的英文文章进行Medline数据库电子检索。选择该时间范围是因为在此期间手术策略、抑酸治疗及定位技术发生了根本性变化。
大多数胃泌素瘤位于“胃泌素瘤三角区”,包括胰头、十二指肠第一部和第二部。约20%的胃泌素瘤与1型多发性内分泌腺瘤病(MEN1)相关,50% - 60%的肿瘤在诊断时为恶性。生化证据支持手术,其中十二指肠切开术是重要组成部分。只有完整切除肿瘤才能使5年和10年生存率达到90%。保留幽门的胰十二指肠切除术可能是MEN1-ZES的首选术式。