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. 1976 Feb;183(2):167–173. doi: 10.1097/00000658-197602000-00014

Basal and meat extract plasma gastrin before and after parietal cell vagotomy and selective gastric vagotomy with drainage in patients with duodenal ulcer.

J E Fischer, E Kragelund, A Nielson, R I Wesdorp
PMCID: PMC1344080  PMID: 1247315

Abstract

Basal and meat extract stimulated plasma gastrin (PG) levels and basal and stimulated gastric acid secretion were evaluated pre and postoperatively in duodenal ulcer patients who underwent parietal cell vagotomy without antral drainage (normal duodena) (PC, n=32) or selective vagotomy with drainage (pyloric stenosis) (SV +P, n=11). Before operation, both groups had comparable basal PG values of 52+/-13 pg/ml (PCVP) AND 51+/-18 PG/ML (SV+P), while the peak gastrin level to meat extract stimulation was 173+/-40 pg/ml for the total group of patients. After both operations basal PG levels increased (107+/-18 pg/ml (PCV) and 152+/-45 pg/ml (SV+P) and the gastrin response to meat extract stimulation was augmented after PCV, while the response after SV+P was the same as before operation. Patients with PCV often demonstrated an acid response following meat extract stimulation (3.6+/-0.9 mEq HC1/hr), and pentapeptide stimulation (18.8+/-2.0 mEq/hr) while patients with SV/P showed a minimal response (1.3+/-1.2 mEq HC1/hr meat extract), and 10.7+/-1.8 mEq/hr pentapeptide stimulation. The comparatively intact acid response in the PCV patients may augur a high ultimate recurrence rate.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amdrup B. M., Griffih C. A. Selective vagotomy of the parietal cell mass: Part I: With preservation of the innervated antrum and pylorus. Ann Surg. 1969 Aug;170(2):207–214. doi: 10.1097/00000658-196908000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Amdrup B. M., Griffith C. A. The effect of insulin upon the secretory response to feeding in dog with selective vagotomy of the parietal cell mass. Scand J Gastroenterol. 1970;5(8):655–665. [PubMed] [Google Scholar]
  3. Amdrup E., Jensen H. E. Selective vagotomy of the parietal cell mass preserving innervation of the undrained antrum. A preliminary report of results in patients with duodenal ulcer. Gastroenterology. 1970 Oct;59(4):522–527. [PubMed] [Google Scholar]
  4. Amdrup E., Johnston D., Goligher J. C. 110 highly selective vagotomies without drainage (HSV) for duodenal ulcer. Gut. 1970 Dec;11(12):1062–1062. [PubMed] [Google Scholar]
  5. Amdrup E., Kragelund E., Humphrey C. S., Smith R. B., Goligher J. C., Johnston D. Evidence for partial vagal reinnervation of the stomach after highly selective vagotomy without a drainage procedure (HSV) for duodenal ulcer in man. Gut. 1971 Oct;12(10):866–866. [PubMed] [Google Scholar]
  6. Clark C. G., Lewin M. R., Stagg B. H., Wyllie J. H. Effect of proximal gastric vagotomy on gastric acid secretion and plasma gastrin. Gut. 1973 Apr;14(4):293–299. doi: 10.1136/gut.14.4.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Clarke R. J., Allan R. N., Alexander-Williams J. The effect of retaining antral innervation on the reductions of gastric acid and pepsin secretion after vagotomy. Gut. 1972 Nov;13(11):894–899. doi: 10.1136/gut.13.11.894. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dent R. I., James J. H., Want C. A., Deftos L. J., Talamo R., Fischer J. E. Hyperparathyroidism: gastric acid secretion and gastrin. Ann Surg. 1972 Sep;176(3):360–369. doi: 10.1097/00000658-197209000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Giles G. R., Clark C. G. Gastric secretion stimulated by meat extract in man. Scand J Gastroenterol. 1966;1(3):159–166. doi: 10.1080/00365521.1966.11800629. [DOI] [PubMed] [Google Scholar]
  10. Goligher J. C. The comparative results of different operations in the elective treatment of duodenal ulcer. Br J Surg. 1970 Oct;57(10):780–783. doi: 10.1002/bjs.1800571023. [DOI] [PubMed] [Google Scholar]
  11. Grassi G., Orecchia C., Sbuelz B., Grassi G. B., Jr Early results of the treatment of duodenal ulcer by ultraselective vagotomy without drainage. Surg Gynecol Obstet. 1973 May;136(5):726–728. [PubMed] [Google Scholar]
  12. HUNTER W. M., GREENWOOD F. C. Preparation of iodine-131 labelled human growth hormone of high specific activity. Nature. 1962 May 5;194:495–496. doi: 10.1038/194495a0. [DOI] [PubMed] [Google Scholar]
  13. Hedenstedt S., Lundquist G., Moberg S. Selective proximal vagotomy (SPV) in the treatment of duodenal ulcer. A preliminary report. Acta Chir Scand. 1972;138(6):591–596. [PubMed] [Google Scholar]
  14. Herrington J. L., Jr, Sawyers J. L., Scott H. W., Jr A 25-year experience with vagotomy-antrectomy. Arch Surg. 1973 Apr;106(4):469–474. doi: 10.1001/archsurg.1973.01350160087014. [DOI] [PubMed] [Google Scholar]
  15. Holle F., Bauer H., Holle G., Konz B., Lissner J., Wünsch E. Clinical results of selective proximal vagotomy (S.P.V.) in gastro-duodenal-ulcer (GDU). A 7-years follow-up-study of 732 cases. Langenbecks Arch Chir. 1972;330(3):197–208. doi: 10.1007/BF01261699. [DOI] [PubMed] [Google Scholar]
  16. Humphrey C. S., Wilkinson A. R. The value of preserving the pylorus in the surgery of duodenal ulcer. Br J Surg. 1972 Oct;59(10):779–783. doi: 10.1002/bjs.1800591009. [DOI] [PubMed] [Google Scholar]
  17. Interone C. V., Del Finado J. E., Miller B., Bombeck T., Nyhus L. M. Parietal cell vagotomy. Studies of gastric emptying and observations of protection from histamine-induced ulcer. Arch Surg. 1971 Jan;102(1):43–44. doi: 10.1001/archsurg.1971.01350010045011. [DOI] [PubMed] [Google Scholar]
  18. Interone C. V., Del Finado J. E., Miller B., Bombeck T., Nyhus L. M. Parietal cell vagotomy. Studies of gastric emptying and observations of protection from histamine-induced ulcer. Arch Surg. 1971 Jan;102(1):43–44. doi: 10.1001/archsurg.1971.01350010045011. [DOI] [PubMed] [Google Scholar]
  19. Jaffe B. M., Clendinnen B. G., Clarke R. J., Williams J. A. Effect of selective and proximal gastric vagotomy on serum gastrin. Gastroenterology. 1974 May;66(5):944–953. [PubMed] [Google Scholar]
  20. Johnston D., Goligher J. C., Pulvertaft C. N., Walker B. E., Amdrup E., Jensen H. E. The two- to four-year clinical results of highly selective vagotomy (parietal-cell vagotomy) without a drainage procedure for duodenal ulcer. Gut. 1972 Oct;13(10):842–842. [PubMed] [Google Scholar]
  21. Johnston D., Wilkinson A. R. Highly selective vagotomy without a drainage procedure in the treatment of duodenal ulcer. Br J Surg. 1970 Apr;57(4):289–296. doi: 10.1002/bjs.1800570414. [DOI] [PubMed] [Google Scholar]
  22. Jordan P. H., Jr, Condon R. E. A prospective evaluation of vagotomy-pyloroplasty and vagotomy-antrectomy for treatment of duodenal ulcer. Ann Surg. 1970 Oct;172(4):547–563. doi: 10.1097/00000658-197010000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Korman M. G., Hansky J., Coupland G. A., Cumberland V. H. Serum gastrin in duodenal ulcer. IV. Effect of selective gastric vagotomy. Gut. 1972 Mar;13(3):163–165. doi: 10.1136/gut.13.3.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Korman M. G., Hansky J., Coupland G. A., Cumberland V. H. Serum gastrin response to insulin hypoglycaemia: studies after parietal cell vagotomy and after selective gastric vagotomy. Scand J Gastroenterol. 1973;8(3):235–239. [PubMed] [Google Scholar]
  25. Korman M. G., Hansky J., Scott P. R. Serum gastrin in duodenal ulcer. 3. Influence of vagotomy and pylorectomy. Gut. 1972 Jan;13(1):39–42. doi: 10.1136/gut.13.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Korman M. G., Soveny C., Hansky J. Extragastric gastrin. Gut. 1972 May;13(5):346–348. doi: 10.1136/gut.13.5.346. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Kragelund E., Fischer J. E., Nielsen A. Meat extract-stimulated gastric acid secretion before and after parietal cell vagotomy without antrum drainage and selective gastric vagotomy with drainage in patients with duodenal ulcer. Ann Surg. 1974 Feb;179(2):174–178. doi: 10.1097/00000658-197402000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Kronborg O. A follow-up of patients operated upon for recurrence after vagotomy and drainage for duodenal ulcer. Scand J Gastroenterol. 1973;8(2):123–128. [PubMed] [Google Scholar]
  29. Kronborg O., Madsen P. A controlled, randomized trial of highly selective vagotomy versus selective vagotomy and pyloroplasty in the treatment of duodenal ulcer. Gut. 1975 Apr;16(4):268–271. doi: 10.1136/gut.16.4.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Kronborg O., Stadil J., Rehfeld J., Christiansen P. M. Relationship between serum gastrin concentrations and gastric acid secretion in duodenal ulcer patients before and after selective and highly selective vagotomy. Scand J Gastroenterol. 1973;8(6):491–496. [PubMed] [Google Scholar]
  31. McGuigan J. E. Immunochemical studies with synthetic human gastrin. Gastroenterology. 1968 Jun;54(6):1005–1011. [PubMed] [Google Scholar]
  32. McGuigan J. E., Trudeau W. L. Differences in rates of gastrin release in normal persons and patients with duodenal-ulcer disease. N Engl J Med. 1973 Jan 11;288(2):64–66. doi: 10.1056/NEJM197301112880202. [DOI] [PubMed] [Google Scholar]
  33. Mydland W. E., Bartholomew L. G., Ferris D. O. Hemorrhage as a Complication of Gastro-enterostomy. Ann Surg. 1956 Dec;144(6):950–952. doi: 10.1097/00000658-195612000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Schrumpf E., Roland M., Liavåg I. Serum gastrin and gastric acid secretion before and after proximal gastric vagotomy. Scand J Gastroenterol. 1974;9(2):115–118. [PubMed] [Google Scholar]
  35. Wesdorp R. I., Fischer J. E. Plasma-gastrin and acid secretion in patients with peptic ulceration. Lancet. 1974 Oct 12;2(7885):857–860. doi: 10.1016/s0140-6736(74)91199-4. [DOI] [PubMed] [Google Scholar]
  36. Wilkinson A. R., Johnston D. Effect of truncal, selective and highly selective vagotomy on gastric emptying and intestinal transit of a food-barium meal in man. Ann Surg. 1973 Aug;178(2):190–193. doi: 10.1097/00000658-197308000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]

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