Treatment of Zollinger-Ellison Syndrome in Young Patients with Large Pancreatic Head Gastrinoma Not Amenable to Enucleation

This protocol addresses Zollinger-Ellison syndrome in a specific and surgically demanding situation: a young patient presenting with a large gastrinoma located in the head of the pancreas that is not technically amenable to simple enucleation.

Young age is a central factor in this scenario. Combined with a large pancreatic head gastrinoma that cannot be removed by enucleation, it drives the selection of a more extensive operative approach than would otherwise be considered.

When enucleation is not feasible in this setting, a major pancreatic resection is indicated. The structured protocol specifies the procedure of choice for this patient profile — and the rationale that supports it.