Pancreatic vein catheterization with gastrin assay in normal patients and in patients with the Zollinger-Ellison syndrome

Abstract

Simultaneous catheterization of the aorta and the caval, portal, and pancreatic veins with blood sampling for gastrin radioimmunoassay was performed in three patients with the Zollinger-Ellison syndrome and in five control patients without peptic ulcer disease. In the controls the gastrin concentrations in the pancreatic veins ranged from 15 to 148 pg/ml (mean, 65; median, 67). Pre- and postoperative catheterizations were performed in two of the Zollinger-Ellison patients, and very high gastrin concentrations in several pancreatic veins indicated the occurrence of multiple tumors, whereas angiography was able to reveal only one tumor in one of the patients. Twelve months after extirpation of the tumors and total gastrectomy, gastrin concentrations in peripheral as well as pancreatic venous blood were lower but still pathologically high. The third patient was catheterized twice, two and twelve months after tumor extirpation and total gastrectomy. The gastrin values from this patient were within the range of the reference group except for one pancreatic vein with slightly increased concentrations. The gastrin concentration did not increase in the interval between the two catheterizations. No complications were noted. The triple catheterization technic with blood sampling for hormone assay is advocated as a diagnostic tool and as a localization procedure in patients with suspected or proved Zollinger-Ellison syndrome.