Management

Pharmacological control of gastric acid hypersecretion is attempted in the period preceding surgery. Omperazole (20-200 mg a day) is considered the initial drug of choice.

Most gastrinomas are found to the right of the superior mesenteric vessels, in the head of the pancreas or duodenum in the so-called gastrinoma triangle. Intraoperative ultrasound may be employed to help with identification of the tumor. In addition, transillumination via intraoperative endoscopy can help to identify small tumors of the duodenum.

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