THE DIAGNOSIS AND TREATMENT OF GASTRINOMA:REPORT OF 17 CASES

Objective.To study the experience of diagnosis and treatment of gastrinoma. Methods.A retrospective study of 17 patients with gastrinoma seen from 1978 through 1998 in PUMC hospital. Results.Three of the 17 cases were associated with multiple endocrine neoplasia type I(MEN I)syndrome.Tumors dispersed extensively in pancreas(31%),duodenum(25%),lymphnode(19%)and other place(25%).Ultrasonography and computed tomography(CT)were sensitive in localizing tumor in pancreas and liver,but were not so well for small tumor in duodenum and lymph node.The angiography,percutaneous transhepatic portal sampling(PTPS),scintigraphy and endoscopic ultrasonography(EUS)also can be used.Sixteen of 17 patients underwent 38 operations and 56 percent of the 16 cases underwent several operations.Seven patients at last performed total gastrectomy that was still considered as a choice of treatment.Tumor resection was rare because the advancing of tumor in most cases. Conclusions.Diagnosing gastrinoma in its early stage and striving for the tumor resection and reducing the metastasis of liver were the cruxes for good prognosis.