ABSTRACT
In the light of 24 cases, routine total gastrectomy in the treatment of Zollinger-Ellison's syndrome should be abandoned in favour of the removal of gastrin-secreting tissue. This treatment which gives just as good results on the ulcer disease, also has the advantage of removal of the tumour tissue malignant in almost 2/3 of cases. Removal of the gastrin secreting tissue thus becomes the operation of choice. Total gastrectomy remains a last resort operation if it proves impossible to find or remove the gastrinoma, or, if after removal of the original tumour, there occurs a relapse of the ulcers or spread of the neoplasm.
Subject(s)
Gastrectomy , Gastric Mucosa/metabolism , Zollinger-Ellison Syndrome/surgery , Adult , Aged , Duodenum/surgery , Female , Gastric Mucosa/surgery , Humans , Male , Middle Aged , Pancreatectomy , Pancreatic Neoplasms/surgery , Peptic Ulcer/surgery , Zollinger-Ellison Syndrome/diagnosis , Zollinger-Ellison Syndrome/pathologyABSTRACT
The authors report an unusual personal case of a diverticulum of Vater projecting into the lumen of the duodenum. The authors comment on the clinical, pathological and pathogenic findings of this embryological abnormality. Finally, they recall a few rules to avoid operative complications by a routine search for the ratios between the diverticulum of the duodenum and the papilla or the bile and pancreatic ducts.