Medical management of patients with Zollinger-Ellison syndrome who have had previous gastric surgery: a prospective study

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 94; no. 2; p. 294
• Main Authors: Maton, P N, Frucht, H, Vinayek, R, Wank, S A, Gardner, J D, Jensen, R T
• Format: Journal Article
• Language: English
• Published: United States 01.02.1988
• Subjects: Adolescent; Adult; Aged; Famotidine; Female; Gastrectomy; Gastric Acid - metabolism; Humans; Male; Middle Aged; Prospective Studies; Ranitidine - therapeutic use; Thiazoles - therapeutic use; Vagotomy; Vagotomy, Proximal Gastric; Zollinger-Ellison Syndrome - drug therapy; Zollinger-Ellison Syndrome - metabolism; Zollinger-Ellison Syndrome - surgery
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1016/0016-5085(88)90415-5

We examined prospectively the criteria for medical management in 16 patients with Zollinger-Ellison syndrome who had had previous gastric surgery. Each patient received sufficient antisecretory medication to lower gastric acid output to less than 10 mEq/h during the last hour before the next dose of drug. The 7 patients with a vagotomy but no gastric resection were symptom-free and had no mucosal disease. Of 9 patients with a partial gastrectomy, 7 had mucosal disease, with or without symptoms, and 6 of the 7 patients had acid outputs of 5-10 mEq/h. In these patients, antisecretory medication was increased to reduce output to less than 5 mEq/h and symptoms and mucosal abnormalities resolved in each patient. Patients with Zollinger-Ellison syndrome and a vagotomy can be treated safely by reducing acid secretion to less than 10 mEq/h, but in patients with a partial gastrectomy, acid secretion must be reduced to less than 5 mEq/h, and adequacy of therapy must be checked further by endoscopy.