Biochemically curative surgery for gastrinoma in multiple endocrine neoplasia type 1 patients

Table 2 Results of extirpation or partial duodenectomy for duodenal gastrinomas in patients with multiple endocrine neoplasia type 1

No.	Age	Gender	ZES	Ulcer diseases	Ulcer related operation	MEN 1 related diseases	Pre-first duodenectomy IRG (pg/mL)	Localization of gastrinoma			Operation	Post-duodenectomy IRG (pg/mL)	Gastrinoma			Metastases		Pancreas NETs	Prognosis present status (post-op yr)	Postoperativesecretin or calcium test
								SASI	GIF	CT			Location	Number	Size (mm)	N	L
4	49	M	+	GU 1984	GX 1984	HPTPit NET	3,180	GDA	ND	PNET	DX, DP, St ParX 1996 Sep	50	D	9	1-7	0	0	1(gluc)	Alive well, after TParX (2004 Jul) PitX (2006 Oct) (13 yr 10 mo)	Negative
				JU 1995
5	61	F	+	GU 1974	GX 1974	HPT	400	GDA	ND	ND	St Par X 1984 Apr	230 → 140	D	5	2-4	0	0	2	Alive well, (14 yr 4 mo) no recur	Negative
							↓
				JU 1975	JX 1975		230	GDA	ND	ND	DX 1996 Apr
							(post Par X)				DX 2004 Nov	170 → 70	D	1	4	0	0	0
6	56	F	+	DU 1997	-	HPT	580	GDA	ND	ND	PX 1997 Feb	885 → 68	D	3	1-2	1	0	3	Alive well, with mult PNET (9 yr 8 mo)	Negative
							↓				St Par X 1999 Jul
							385 → 885				DX 2001 Jan
							(post Par X)				DX 2007 Jan	400 → 54	D	2	1-3	0	0	0
7	44	F	+	GU 1992	-	PNET					PPPD 1993 Jan	137	-	-	-	0	0	1	Alive well,(9 yr 4 mo) no recur	Negative
						HPT					St Par X 1993 Apr
							811	GDA	Dsmt	ND	DX 2001 Apr	811 → 28	D	1	9	0	0	0
8	33	M	-	- -	-	HPT	3240	GDA	Dsmt	ND	ParX 1993	44	D	1	10	1	0	mult (gluc)	Alive well, (7 yr) No recur	Negative
											St ParX 2003 May
											DX, DP 2003 Jul
9	54	F	+	GU, DU 2005	-	Ins (multi)					DP 1978	149	D	2	6, 12	3	0	1	Alive well, (1 yr 6 mo) no recur	Negative
						HPT	49 500	n n	Dsmt	Dsmt	TParX, TX 1989
						Pit NET			Gsmt	Gsmt	PitX,γ-K 1989, 1995		P(H)	1	15
						GNET				LNMets	DX, GX, LNX 2009 Feb

ZES: Zollinger-Ellison syndrome; SASI: Selective arterial secretagogue injection test; GIF: Gastrointestinal fibroscopy; CT: Computed tomography; IRG: Serum immunoreactive gastrin concentration; N: Lymph node metastasis; L: Liver metastasis; NET: Neuroendocrine tumors; postop: Postoperative; F: Female; M: Male; GU: Gastric ulcer; JU: Jejunal ulcer; DU: Duodenal ulcer; GX: Partial gastrectomy; JX: Partial jejunectomy; HPT: Hyperparathyroidism; P: Pancreatic; Pit: Pituitary; G: Gastric; NET: Neuroendocrine tumor; Ins: Insulinoma; mult: Multiple; ParX: Parathyroidectomy; GDA: Gastroduodenal artery; ND: Not detected; Dsmt: Duodenal submucosal tumor; PX: Partial resection of the pancreas; LN: Lymph node; DX: Extirpation of duodenal gastrinoma and/or partial resection of duodenum; St Parx: Subtotal parthyroidectomy; T Parx: Total parathyroidectomy; TX: Transplantation of parathyroid gland; PPPD: Pylorus preserving pancreaticoduodenectomy; DP: Distal pancreatectomy; D: Duodenum; gluc: Glucagonoma; Mets: Metastasis; P(H): Pancreas head; LNX: Dissection of regional lymph nodes; NN: Not needed; NP: Not performed; no recur: No recurrence.