Role of selective arterial secretin injection test in treatment of gastrinoma.

Background/aims: To study whether use of the selective arterial secretin injection test increased the rate of tumor localization and curative resection in patients with gastrinoma.
Methodology: Nine patients with gastrinoma were divided into 2 groups, before and after introduction of selective arterial secretin injection test; 4 patients before 1987 (Group 1) and 5 patients after 1988 (Group 2). Clinical results were compared retrospectively between groups.
Results: Localization of primary gastrinoma was made with conventional imaging studies in 1 of the 4 patients in Group 1 and 3 of the 5 patients in Group 2. In contrast, use of the selective arterial secretin injection test was able to localize the primary tumor in 4 of the 5 patients in Group 2. Total gastrectomy was carried out in the 4 patients in Group 1, and pancreatoduodenectomy was the most frequently performed procedure (3 patients) in Group 2. Rate of curative resection was 25% and 80% in Groups 1 and 2, respectively.
Conclusions: These results indicate that combining selective arterial secretin injection test with conventional imaging studies contributes to increasing rate of curative resection of gastrinoma.