Clark C G, Chowcat N L, Lewin M R, Gilbert J M, Gelister J S, Boulos P B
Br J Surg. 1986 Apr;73(4):248-52. doi: 10.1002/bjs.1800730403.
Between 1971 and 1983, 31 males and 13 females were found to have peptic ulceration associated with hypergastrinaemia. An antral G-cell lesion was present in 11 (25 per cent) and a gastrinoma in 14 (32 per cent). There were 11 patients with multiple endocrine adenomatosis (MEA) (25 per cent) and 4 (9 per cent) with primary hyperparathyroidism. Four patients (9 per cent) were unclassified. Length of history and level of gastrin did not differentiate between the groups and an average of 2.5 operations was performed per patient, while the overall mortality was 27.3 per cent. The patients with G-cell lesions were significantly younger than all the other groups (P less than 0.01). Partial gastrectomy adequately treated G-cell hyperplasia. Total gastrectomy was required to treat pancreatic gastrinomata but additional pancreatic resection did not improve the outcome. In MEA, parathyroidectomy did not influence the treatment of a gastrinoma. This is the first recorded experience of surgery for hypergastrinaemia in the United Kingdom and the outcome of such a retrospective study may be a guide to the future management of these conditions.
在1971年至1983年间，发现31名男性和13名女性患有与高胃泌素血症相关的消化性溃疡。11例（25%）存在胃窦G细胞病变，14例（32%）存在胃泌素瘤。有11例患者（25%）患有多发性内分泌腺瘤病（MEA），4例（9%）患有原发性甲状旁腺功能亢进。4例患者（9%）未分类。病史长短和胃泌素水平在各组之间无差异，每位患者平均接受2.5次手术，总体死亡率为27.3%。G细胞病变患者比所有其他组明显年轻（P<0.01）。部分胃切除术可有效治疗G细胞增生。治疗胰腺胃泌素瘤需要全胃切除术，但额外的胰腺切除术并不能改善预后。在MEA中，甲状旁腺切除术不影响胃泌素瘤的治疗。这是英国首次记录的高胃泌素血症手术经验，此类回顾性研究的结果可能为这些疾病的未来管理提供指导。
