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- W267730335 abstract "This chapter discusses current views on the surgery of gastrinoma in the post-cimetidine era. Total gastrectomy was advised as a life-saving procedure when the concept of the ulcerogenic islet cell tumor was introduced in 1955. Removal of all acid-secreting surfaces was the only certain method of controlling the exaggerated gastric hypersecretion associated with gastrin-induced hyperplasia of the parietal cell mass. This therapeutically static situation persisted for almost two decades till the H 2 -receptor antagonists were introduced. Metiamide, though effective, was associated with granulocytopenia, which made it unacceptable for general clinical use. By contrast, cimetidine provided immediate dramatic and effective clinical relief of symptoms, which ensured its widespread acceptance. Cimetidine is well tolerated and has infrequent and minor side effects. It is usually taken orally in a dose of 300 mg with meals and during bedtime, but it can be taken intravenously or in rectal suppositories. The maximum concentration occurs in 1 to 1.5 hours, and it is effective for approximately 4 hours. Most of the drug is excreted in the urine within 24 hours, but some is excreted in the bile. Given the usual doses, cimetidine inhibits not only fasting secretion but also secretion induced by sham feeding, pentagastrin, fundic distension, insulin, caffeine, and eating. The drug is also effective in depressing the cephalic vagal phases of gastric secretion." @default.
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- W267730335 date "1983-01-01" @default.
- W267730335 modified "2023-09-27" @default.
- W267730335 title "Current views on the surgery of gastrinoma in the post-cimetidine era" @default.
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- W267730335 doi "https://doi.org/10.1016/b978-0-407-02317-8.50015-x" @default.
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