Feurle G E, Helmstädter V, Hoevels J, Wenzel-Herzer G, Klempa I
Dtsch Med Wochenschr. 1982 May 7;107(18):697-704. doi: 10.1055/s-2008-1070006.
A gastrinoma was found in 12 of 23 patients with Zollinger-Ellison syndrome. Those with gastrinoma were not different from those without as regarded fasting gastrin level, increased gastrin secretion after secretin and calcium, acid secretion, or survival time. Five of the 23 patients have died, four immediately postoperatively, the fifth of the metastasizing tumour. Treatment with the H2-receptor antagonist cimetidine avoided emergency operation and thus decreased operative mortality, giving time for localization by ultrasound, computed tomography and selective arteriography. The rate of false-negative results was high. Transhepatic selective catheterization of the pancreatic veins with gastrin determination gives localization of the tumour and identification of the secreted hormone. In three patients tumour resection was possible under cover of H2-receptor antagonist administration which normalized gastrin and acid secretion. There is a change in the treatment of the Zollinger-Ellison syndrome, away from total gastrectomy to conservative treatment with H2-receptor antagonists and an attempt of curative treatment by removal of the tumour.
在23例卓-艾综合征患者中，12例发现有胃泌素瘤。有胃泌素瘤的患者与无胃泌素瘤的患者在空腹胃泌素水平、注射胰泌素和钙剂后胃泌素分泌增加情况、胃酸分泌或生存时间方面并无差异。23例患者中有5例死亡，4例于术后即刻死亡，第5例死于肿瘤转移。使用H2受体拮抗剂西咪替丁进行治疗避免了急诊手术，从而降低了手术死亡率，为通过超声、计算机断层扫描和选择性动脉造影进行定位赢得了时间。假阴性结果的发生率较高。经肝选择性胰静脉插管并测定胃泌素可实现肿瘤定位并识别所分泌的激素。在3例患者中，在给予H2受体拮抗剂的掩护下进行了肿瘤切除，胃泌素和胃酸分泌恢复正常。卓-艾综合征的治疗发生了变化，从全胃切除术转向使用H2受体拮抗剂进行保守治疗，并尝试通过切除肿瘤进行根治性治疗。
