Effect of truncal vagotomy with pyloroplasty or with antrectomy on food-stimulated gastrin values in patients with duodenal ulcer.

Abstract

Abstract We have studied the effect of vagotomy with pyloroplasty (V + P) or antrectomy (V + A) on the serum gastrin response to a meal in 17 patients with duodenal ulcer (DU). The mean fasting gastrin value was 129 ± 11 pg. per milliliter, which differed significantly from that for ten control subjects (84 ± 7 pg./ml.). After a standard meal, gastrin rose to 189 ± 21 pg. per milliliter in DU patients and to 122 ± 11 pg. per milliliter in control subjects. Three to six months postoperatively, V + P (ten patients) resulted in a significant increase of basal gastrin, from a preoperative value of 130 ± 9 to 167 ± 14 pg. per milliliter postoperatively. After a meal, gastrin increased to 198 ± 26 pg./ml. preoperatively and to 268 ± 40 pg./ml. postoperatively. V + A (seven patients) caused no significant change in basal or food-stimulated gastrin values. After V + P or V + A, basal and pentagastrin-stimulated acid output was diminished approximately 70 percent. Since antrectomy caused no significant change in either basal or postprandial gastrin values, it appears that there are important extra-antral sources of gastrin and this gastrin can be released into the circulation by food.