The Place of Surgery in the Zollinger-Ellison Syndrome

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Abstract
AVAILABILITY of effective medical therapy for the Zollinger–Ellison syndrome (ZES)1 2 3 has removed much urgency from decisions about treatment and encouraged reevaluation of various options.3 4 5 A recurring question posed by clinicians is whether such patients should undergo exploratory surgery. Confusion arises about whether exploration is seen as an additional diagnostic procedure, an operation directed against the tumor, an attempt to control acid secretion regardless of tumor status, or all the above. Since in most cases the disease is malignant,6 7 8 the ideal treatment would be a safe type of chemotherapy that would suppress endocrine function and halt the spread of the tumor. . . .