Gastrinoma: Importance of localization. Anatomical, surgical and diagnostic perspective

Gastrinoma is also commonly called as Zollinger-Ellison syndrome. It accounts for about 15- 20% of Pancreatic Neuroendocrine Tumors. In These tumors There is excessive and overproduction of the hormone gastrin, leading to excessive secretion of gastric acid. The patients suffer from multiple and recurrent peptic ulcers that are in most cases resistant to medical treatment or that are in uncommon locations. In most cases these tumors are small, having a distribution that is diverse and difficult to detect complicated with the fact that patients present with varied clinical signs and not detected or diagnosed at early stages .As such a high suscpicion about Gastrinoma should always be there once a patient fails to respond to proton pump therapy  in case of refractory peptic ulcer disease . Despite extensive preoperative localization studies and meticulous surgical exploration, some patients with gastrinoma have no tumor demonstrable at laparotomy.