Development of New techniques to Aid in Radical Resection of Multiple Gastrinomas in Zollinger-Ellison Syndrome

Masayuki Imamura, Yutaka Shimada, Yasuaki Hattori, Takayoshi Tobe

First Department of Surgery, Faculty of Medicine, Kyoto University

We have developed two useful tchniques for curative resectioning of multiple microgastrinomas. The Selective Arterial Secretin Injection test (SASI test) demontratis the feeding artery of gastrinomas, and the Interoperative Secretin test (IOS test) estimates the curability of the resection during the operation. These tests have been developed on the basis of the direct action of secretin in stimulating gastrinoma cells to release gastrin. Ten patients with Zollinger-Ellison syndrome were examined by SASI test and gastrinomas were located in all of them, though diagnostic imaging techniques or portal venous blood sampling also located some of them. Based on the results of the SASI test, pancreatoduodenectoy was performed in four patients. All of them had multiple microgastrinomas and have been cured so far. The ISO test was useful in each case to determine the extent of radicality of the operation. We hope that these two tests will be used routinely in performing curative resection of gastrinomas.

Key words
gastrinoma, selective arterial secretin injection test, curative resection of gastrinoma

Reprint requests
Masayuki Imamura First Department of Surgery, Faculty of Medicine, Kyoto University
54 Kawahara-cho, Shogoing, Sakyo-ku, Kyoto, 606 JAPAN

Accepted
November 8, 1989

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