Management of Zollinger–Ellison Syndrome

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Abstract
To the Editor: Our experience with 92 surgically treated patients with Zollinger–Ellison syndrome (ZES), 1 , 2 66 of whom have been followed for five or more years, together with more recent experience with both cimetidine and ranitidine in the treatment of ZES, prompts us to take issue with the position of Dr. McCarthy3 that "pharmacologic control of acid secretion is the preferred treatment" of this syndrome. His position assumes universal and permanent efficacy of the therapeutic agents, but recent reports1 , 4 5 6 have documented "escape" from the therapeutic benefits of cimetidine, or refractoriness to the drug, in ZES. Similarly, the collected experience of investigators . . .