Department of Surgery home page Home Divisions Physicians Locations Contact Us Education Society of Graduate Surgeons
Keck School of Medicine of USC - University of Southern California Keck School of Medicine of USC University of Southern California
Department of Surgery
Department links
Home Physicians Locations Education Society of Graduate Surgeons Contact Us Divisions and Institutes
Hepatobiliary, Pancreas and Abdominal Organ Transplant
Main navigation links
Areas of Expertise dot Liver Surgery dot Pancreatic and Biliary Surgery dot Organ Transplant dot Research dot Clinical Trials
Patient Guides and Resources dot Support Groups dot Virtual Tour dot Calendar of Events dot Web Links dot Contact Us


What is a gastrinoma

Gastrinomas are rare endocrine tumors and commonly present with severe recurrent peptic ulcer disease. More than 60% of gastrinomas are cancerous and the tumor eventually spreads to the liver and other parts of the body.

How are gastrinomas diagnosed?

A diagnosis of a gastrinoma should be considered in a patient with peptic ulcers that recur frequently and are resistant to treatment. A biochemical study to measure the level of gastrin and its response to a hormone called secretin is utilized to make the diagnosis.

Once a diagnosis is made, localizing the tumor is important. Most gastrinomas are small lesions and therefore, localizing the tumor may be difficult. Some of the tests that are performed to localize the tumor include a CT scan, octreotide scan and MRI and an endoscopic ultrasound.

An experienced surgeon will detect these tumors at surgery even when they are not visible on preoperative imaging tests.

How are gastrinomas treated?

Treatment of choice for gastrinoma is to remove the surgically where possible. Peptic ulcers must be aggressively treated and controlled prior to surgery. The type of surgery for gastrinomas depends on the location of the tumor. Since these tumors may frequently occur at more than one spot in the pancreas and the surrounding tissues more than one procedure may be required. The following operative procedures may be utilized to treat gastrinomas.

  • Enucleation: Many small gastrinomas in the pancreas may be treated by enucleation alone. This is a procedure of choice for patients that have small tumors (less than 1cm) where the tumor is located on the surface of the pancreas.
  • Resection of the pancreas: in patients with large tumors a distal pancreatectomy or a Whipple operation may be indicated depending on where the tumor is located in the pancreas.
  • Duodenal exploration: Gastrinomas often occur in the wall of the duodenum (first part of the intestine) and therefore opening duodenum and carefully feeling it to remove any tumors in this area is important.
  • Lymph nodes: In some patients the tumor may be located in the lymph glands outside the pancreas therefore careful palpation and removal of these glands is important at the time of surgery
Other islet cell tumors of the pancreas

Other neuroendocrine tumors such as glucagonoma, VIPoma and somastatinoma are extremely uncommon tumors. These tumors are malignant in the vast majority of patients and may present as large tumors at the time of diagnosis. Up to 70% of patients have evidence of spread of the tumor at the time of the diagnosis? Aggressive surgical removal of as much tumor as possible is often indicated to relieve some of the severe symptoms that these tumors may cause because of secretion of hormones from these tumors.


Share this page:

For Liver, Pancreas and Bile Duct Surgery, please call (323) 442-7172. For Organ Transplant Information, please call (323) 442-5908

Follow us on Facebook   Follow us on Facebook


USC Hepatobiliary, Pancreas and
Abdominal Organ Transplant

1450 San Pablo Street
Healthcare Consultation Center 4
Suite 6200
Los Angeles, CA 90089

For Liver, Pancreas & Bile Duct Surgery,
please call (323) 442-7172
Fax: (323) 442-7173

For Organ Transplant Information,
please call (323) 442-5908

Fax: (323) 442-5721

Click map to go to directions

Home Faculty and Staff Hospitals and Offices Education/Fellowships Make An Appointment