Zollinger-Ellison syndrome. Recent advances in the management of the gastrinoma.

Because of increasingly effective oral antisecretory agents, gastric acid hypersecretion is now able to be controlled in all patients with Zollinger-Ellison syndrome with the result that the natural history of the gastrinoma is becoming the major determinant of long-term survival. In this article recent advances in the management of the gastrinoma itself are reviewed, including results with new modalities such as intraoperative ultrasound, MRI, and selective gastrin sampling to localize gastrinoma in patients with Zollinger-Ellison syndrome, as well as recent results of the treatment of metastatic and localized gastrinomas.