Barreras R F, Mack E, Goodfriend T, Damm M
Gastroenterology. 1982 May;82(5 Pt 1):953-6.
Patients with the Zollinger-Ellison syndrome have been managed by total gastrectomy and more recently, by the use of H2-receptor antagonists. An alternative approach has been to identify those who might be cured by excision of a pancreatic islet-cell tumor without removal of the stomach. The course of such a patient is reported. A 40-yr-old man with massive gastric hypersecretion, acid-peptic disease, diarrhea, and elevated serum gastrin was treated by excising a pancreatic gastrinoma. Serum gastrin and gastric secretion became and have remained normal for 7 yr. Symptoms ceased and provocative tests with secretin and calcium have remained normal. Three additional patients with Zollinger-Ellison syndrome in whom pancreatic islet-cell tumor resection alone has resulted in long-term cures have been identified. All were middle-aged men with severe diarrhea. These successes, the availability of techniques that permit early identification and localization of gastrinomas, and the advent of H2-receptor antagonists that can control gastric hypersecretion without gastrectomy must be considered in managing patients with gastrinomas.
卓-艾综合征患者过去一直通过全胃切除术进行治疗，最近则采用H2受体拮抗剂进行治疗。另一种方法是确定那些可以通过切除胰岛细胞瘤而不切除胃来治愈的患者。本文报告了这样一位患者的病程。一名40岁男性，有大量胃酸分泌过多、酸相关性疾病、腹泻以及血清胃泌素升高，通过切除胰腺胃泌素瘤进行治疗。血清胃泌素和胃酸分泌恢复正常并在7年中一直保持正常。症状消失，促胰液素和钙激发试验结果一直正常。另外还发现了3例仅通过切除胰岛细胞瘤就实现长期治愈的卓-艾综合征患者。他们均为中年男性，有严重腹泻。在治疗胃泌素瘤患者时，必须考虑到这些成功案例、能够早期识别和定位胃泌素瘤的技术的可用性，以及无需进行胃切除术就能控制胃酸分泌过多的H2受体拮抗剂的出现。
