{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:34:59Z","timestamp":1787808899719,"version":"build-2784847793"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe surgical indications, procedures and outcomes in patients operated for Zollinger\u2010Ellison syndrome (ZES) in multiple endocrine neoplasia type 1 (MEN1) using a large nationwide cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of ZES in MEN1 remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients with ZES diagnosed through the MEN1 AFCE\/GTE network from 1985 to 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 233 ZES patients, 66 (28%) were operated for ZES\u2010related gastrinomas. Thirty\u2010three (51%) procedures aimed to remove gastrinomas and associated pancreatic neuroendocrine tumors (pNET(s)) with appropriate resection. Thirty\u2010two procedures (49%) aimed to remove gastrinomas alone (ZES group). Survival was decreased in patients metastatic at ZES diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Fifteen\u2010year survival among non\u2010metastatic patients was not significantly better in operated patients (82% vs. 70%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.2). Perioperative mortality was nil. Metastatic lymph nodes were found in 30\/42 lymphadenectomies (71%). The choice between pancreaticoduodenectomy versus duodenal focused surgery in the ZES group was associated with pre\u2010operative detection of adenopathies (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.001), leading to more frequent lymphadenectomies (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). Previous pancreatic surgeries (30%) may have influenced the choice of ZES procedures. Gastrin levels were more frequently normalized when the duodenum and the head of pancreas were removed versus more localized duodenal surgeries (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high rate of invaded nodes in lymphadenectomies in MEN1 patients operated for ZES, the absence of operative mortality, and the decreased survival in metastatic patients are indirect arguments for surgery. Pancreaticoduodenectomy may be indicated in young and fit individuals to better control hypergastrinemia and to prevent metastatic progression in the ZES group. Gastrinoma removal is justified when associated with large pNETs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70303","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T03:12:38Z","timestamp":1774062758000},"page":"1300-1311","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Management of Zollinger\u2010Ellison Syndrome in Multiple Endocrine Neoplasia Type 1 an AFCE and GTE Cohort Study. (Association Francophone de Chirurgie Endocrinienne and Groupe d'\u00e9tude des Tumeurs Endocrines)"],"prefix":"10.1002","volume":"50","author":[{"given":"S\u00e9bastien","family":"Gaujoux","sequence":"first","affiliation":[{"name":"Department of General, Visceral, and Endocrine Surgery Piti\u00e9 Salp\u00eatri\u00e8re Hospital, AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Pattou","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery Lille University Hospital  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Cadiot","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Gastro\u2010Enterology Robert\u2010Debr\u00e9 Hospital, Reims\u2010Champagne\u2010Ardennes University  Reims France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Adham","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, Lyon Sud Faculty of Medicine Edouard Herriot Hospital, Hospices Civils de Lyon, Claude Bernard University Lyon 1 (UCBL1)  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bachellier","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery and Liver Transplant Hautepierre Hospital, Strasbourg University  Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Pierre","family":"Bail","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Brest University Hospital  Brest France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Caiazzo","sequence":"additional","affiliation":[{"name":"Department of General and Endocrine Surgery Lille University Hospital  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Carrere","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Toulouse University Hospital  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Chaffanjon","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Vascular and Endocrine Surgery Grenoble University Hospital  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Deguelte","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery Robert\u2010Debr\u00e9 Hospital, Reims\u2010Champagne\u2010Ardennes University  Reims France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Donatini","sequence":"additional","affiliation":[{"name":"Department of General Surgery University Hospital  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Dousset","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal, Hepatobiliary and Endocrine Surgery Cochin Hospital, AP\u2010HP (Paris Public Hospitals)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Faron","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay, Gustave Roussy, INSERM 1018 Oncostat Team  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Gronnier","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery Haut L\u00e9v\u00eaque University Hospital  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Heyd","sequence":"additional","affiliation":[{"name":"Department of Visceral, Digestive and Oncologic Surgery University Hospital, Franche\u2010Comt\u00e9 University  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Christophe","family":"Lifante","sequence":"additional","affiliation":[{"name":"Department of Digestive and Endocrine Surgery, Health Services and Performance Research University Hospital of Lyon Sud and EA 7425 HESPER, University Claude Bernard Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Lubrano","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery University Hospital of Caen  Caen cedex France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Meurisse","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery and Transplantation Li\u00e8ge University Hospital University of Li\u00e8ge  Li\u00e8ge 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