Surgery to Cure the Zollinger–Ellison Syndrome

To the Editor: Norton et al. (Aug. 26 issue) 1 report 10-year surgical-cure rates of 34 percent in 123 patients with sporadic gastrinomas and 0 percent in 28 patients with multiple endocrine neoplasia type 1. The authors' objective was limited to the elimination of discoverable gastrinoma, as determined by measurements of serum gastrin, secretin tests, and imaging studies. A preferable objective would have been to eliminate reliably the aggressive peptic ulcer disease and diarrhea that characterize the Zollinger–Ellison syndrome by suppressing acid secretion with the use of proton-pump–inhibitor therapy. 2 Norton et al. provide little information on morbidity or the functional outcome . . .