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

Table 3 Results of pancreas-preserving total duodenectomy for duodenal gastrinomas in patients with multiple endocrine neoplasia

No.	Age	Gender	ZES	Ulcer diseases	Ulcer related operation	MEN 1 related diseases	Pre-PPTD IRG (pg/mL)	Localization of gastrinoma			Operation		Post-PPTD IRG (pg/ mL)	Gastrinoma			Metastases		Pancreas NETs	Prognosis (post-op yr)	Post-PPTD secretin or calcium test
								SASI	GIF	CT				Location	Number	Size (mm)	N	L
10	51	F	+	DU 1997 Dec	-	HPT	54 800	GDA, IPDA	ND	#6 LN #13 LN	St ParX 2003		216	D	num	1-4	2	0	9 (1; gluc)	Alive well with L Mets (IRG 900) (6 yr 8 mo)	Positive
							↓				Apr
							18 200				PPTD, DP 2003
							(post ParX)				Nov
11	30	M	-	-	-	HPT	820	GDA, IPDA	ND	PNET (uncus tail)	T ParX, TX 2004 Apr		110	D	1	5	0	0	1	Alive well (6 yr) no recur	Negative
							↓
						Pit NET	206				PPTD, DP 2004 Jul
							(post ParX)
12	33	M	+	DU 2004 Mar	-	HPT	3050	GDA, IPDA	Dsmt	ND	T ParX, TX		57	D	1	5	0	0	multi	Alive well (6 yr) no recur	Negative
							↓				2003 Aug
							710				PPTD, DP 2004
							(post ParX)				Aug
13	48	F	-	-	-	HPT	687	IPDA, DPA	Dsmtdiff PNET (D-EUS)	#13LN PNET (< 3 mm) diff	PPTD 2007 Apr		59	D	num	1-5	1	0	multi	Alive well (2 yr 11 mo) no recur	Negative
											T ParX, TX 2007 Sep								diff
14	33	M	+	JU perf 2007 Jan	Patch	HPT	13 900 (post ParX)	GDA	Dsmtdiff PNET (D-EUS)	#17LN Dsmt	T ParX, TX 2001 Dec		255	D	1	8	2	0	multi	Alive well witn N Mets (IRG 371) (2 yr 8 mo)	Positive
											PPTD 2007 Nov								diff
15	57	F	+	DU perf 2006 Jan	GX	HPT	720	GDA, IPDA	ND	ND	T ParX, TX 2007 Mar		42	D	7	2	1	0	0	Alive well (2 yr) no recur	Negative
				JU perf 2006 Jul	JX		↓				PPTD, TG 2008 Aug
				Ileus 2007 May			646
				JU perf 2008 Jul			(post ParX)
16	32	M	+	Es bleeding 2002 Oct		HPT	1630	DGA, SPA	ND	PNET (17 mm)	ParX, PPTD P(T)X	2008 Aug	450	D, P(T)	3, 1	3, 10, 11 10	3	0	3 (> 5 mm)	Alive well (2 mo) no recur	Negative
				DU JU perf 2006 Jan
					JX		1000	DGA, SPA	ND	PNET (5-10 mm)	DP, P(H)X	2009 Jul	94	P(b)	1	4	0	0	multi
				JU perf 2008 Nov	GX, JX

ZES: Zollinger-Ellison syndrome; PPTD: Pancreas preserving total duodenectomy; SASI: Selective arterial secretagogue injection test; op: Operation; GIF: Gastrointestinal fibroscopy; CT: Computed tomography; IRG: Serum immunoreactive gastrin concentration; N: Lymph node metastasis; L: Liver metastasis; NET: Neuroendocrine tumor; F: Female; M: Male; postop: Postoperative; DU: Duodenal ulcer; JU: Jejunal ulcer; perf: Perforation; Es: Esophagus; Patch: Omental patch; GX: Partial gastrectomy; JX: Partial jejunectomy; HPT: Hyperparathyroidism; Pit NET: Pituitary neuroendocrine tumor; ParX: Parathyroidectomy; GDA: Gastroduodenal artery; IPDA: Inferior pancreatoduodenal artery; DPA: Dorsal pancreatic artery; SPA: Splenic artery; ND: Not detected; Dsmt: Duodenal submucosal tumor; diff: Diffuse; D-EUS: Duodenal endoscopic ultrasonography; LN: lymph node; PNET: Pancreatic neuroendocrine tumor; St ParX: Subtotal parathyroidectomy; T ParX: Total parathyroidectomy; TX: Tranplantation of the parathyroid; DP: Distal pancreatectomy; PX: Partial resection of the pancreas; D: Duodenum; P(T): Pancreas tail; num: Numerous; gluc: Glucagonoma; mult: Multiple; NP: Not performed; diff: Diffuse; Met: Metastasis; no recur: No recurrence.