{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:07:39Z","timestamp":1757700459137},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1984,8,1]],"date-time":"1984-08-01T00:00:00Z","timestamp":460166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1984,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The diagnostic and therapeutic criteria that allow differentiation of the Pseudo\u2010Zollinger Ellison syndrome (PsZES) from other ulcerogenic states including neurogenic duodenal ulcer disease, the retained, excluded antrum syndrome (REAS), and the Zollinger\u2010Ellison syndrome (ZES) are documented. Ten additional patients having clinical and diagnostic features of Ps\u2010ZES demonstrated hypergastrinemia of an antral source. Three of the patients had had failed complete vagotomy and drainage procedures and another had a retained excluded antrum after partial gastrectomy. Postoperatively, normal serum gastrin concentrations were attained in the 9 patients who had a definitive antrectomy, with and without concomitant vagotomy. Provocative tests demonstrate that patients with Ps\u2010ZES have an exaggerated serum gastrin response to a meal but not to intravenous secretin. Antral G\u2010cell hyperplasia (AGCH) was observed histochemically in all but one surgically treated patient who is presumed to have G\u2010cell hyperfunction due to pyloric obstruction. One patient with REAS exhibited no appreciable response to a meal or to secretin stimulation; the G cells of the excluded antrum were hyperplastic. None of the patients had historical or endocrine features of multiple endocrine adenopathy, type I (MEA I).<\/jats:p><jats:p>Provocative testing and histochemical determination of the antral G\u2010cell population permits a selective approach to the surgical treatment of patients with persistent or recurrent ulceration due to hyperchlorhydria. Patients with neurogenic duodenal ulcer without hypergastrinemia may reasonably be treated by surgical vagotomy with pyloroplasty or parietal cell vagotomy. Patients proven to have an antral source (without tumor) for their hypergastrinemia (Ps\u2010ZES) should have antrectomy, with or without vagotomy. Patients with gastrinoma (ZES) require excision of tumor(s) with or without total gastrectomy.<\/jats:p>","DOI":"10.1007\/bf01654936","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T08:52:14Z","timestamp":1115542334000},"page":"552-559","source":"Crossref","is-referenced-by-count":11,"title":["Further experience with Pseudo\u2010Zollinger\u2010Ellison syndrome: Its Place in the management of neuroendocrine duodenal ulceration"],"prefix":"10.1002","volume":"8","author":[{"given":"Stanley R.","family":"Friesen","sequence":"first","affiliation":[{"name":"Departments of Surgery and of Pathology and Oncology University of Kansas Medical Center College of Health Sciences and Hospital Kansas City Kansas USA"},{"name":"Department of Surgery University of Kansas Medical Center 66103 Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Tomita","sequence":"additional","affiliation":[{"name":"Departments of Surgery and of Pathology and Oncology University of Kansas Medical Center College of Health Sciences and Hospital Kansas City Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1984,8]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198110000-00011"},{"key":"e_1_2_1_3_1","first-page":"99","volume-title":"Gastrointestinal Hormones","author":"Straus E.","year":"1975"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.13.7.501"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195510000-00015"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197901000-00004"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1972.tb03073.x"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02393111"},{"key":"e_1_2_1_9_1","doi-asserted-by":"crossref","unstructured":"Friesen S.R.:The Zollinger\u2010Ellison syndrome. 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