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Controversies in the Management of ZollingerEllison Syndrome

AARON I. VINIK, M.B., B.Ch., M.D.; and NORMAN THOMPSON, M.D.
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The University of MichiganAnn Arbor, Michigan


Ann Intern Med. 1986;105(6):956-959. doi:10.7326/0003-4819-105-6-956
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The Zollinger-Ellison syndrome is characterized by persistent basal gastric acid hypersecretion due to hypergastrinemia. Death from fulminant ulcer disease is now rarely seen, and death from progression of the tumor has become the major issue. Management of nearly all patients with this disease was previously by total gastrectomy, and no attempt was made to identify or remove the source of gastrin hypersecretion. Over the 3 decades since the syndrome's description, there has been much debate as to the optimal form of management (1-3). Controversial areas include definition of subvarieties of the syndrome, each of which requires a different approach to

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