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Assessing the Cure of the Zollinger-Ellison Syndrome after Gastrinoma Resection
- Muhammad Hammami, MD, PhD
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TO THE EDITOR:
In their recent article on the best approach for follow-up of patients with the Zollinger-Ellison syndrome who had surgical exploration for gastrinoma resection, Fishbeyn and colleagues [1] suggested that a secretin provocative test and two fasting serum gastric determinations should be done after surgery and before hospital discharge; normal tests would be repeated 3 to 6 months and yearly thereafter. However, evaluation of patients in the immediate postoperative period seems to have little clinical utility and can be omitted. First, the authors do not recommend discontinuation of gastric acid antisecretory therapy if normal results are obtained. Second, doing the same tests at 3 to 6 months (as recommended) better predicts recurrence. Finally, to do these tests, antisecretory therapy must be discontinued for several days (approximately 2 days for a return of basal acid output to baseline plus 1 to 2 days to obtain fasting gastrin levels on 2 to 3 separate days), a period that may not be safe or comfortable for patients in the postoperative period.
Muhammad Hammami MD, PhD
King Faisal Specialist Hospital and Research Centre; Riyadh 11211; Saudi Arabia
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
