Usefulness of laparoscope-assisted antrectomy for gastric carcinoids with hypergastrinemia.

The mechanisms responsible for development of gastric carcinoid tumors (type I carcinoids) in type A atrophic gastritis are hyperplasia of enterochromaffin-like cells that are associated with hypergastrinemia, and tumorigenesis. Endoscopic resection and gastrectomy are applied as treatment modalities for gastric carcinoids associated with gastrin hypersecretion. However, since the underlying pathology is the hyperplasia of gastrin-secreting cells and over-production of gastrin in the antropyloric region, antrectomy seems a logical treatment modality. To date, we have performed laparoscopic-assisted anterectomies in 3 cases of type I gastric carcinoid. The lesions have regressed or disappeared in 2 cases, in which resections of the foci were not performed. Furthermore, no has been observed in the other case, in which laparoscopic resection was performed. A laparoscopic antrectomy for type I gastric carcinoid is a minimally invasive treatment relevant to the pathology of the disease, and it is also expected to produce regression or even spontaneous resolution of the tumor.