Effect of unilateral thoracic vagotomy on histamine-stimulated acid secretion in man

Abstract

In the past, the effect of vagotomy on gastric secretion has been considered to be an “all or none” effect [2]. In fact, it has been reported that division of 75% of the vagal fibers at the level of the esophageal hiatus does not affect gastric secretion 151. However, recent studies have demonstrated a segmental vagal innervation of the canine stomach [4]. Although unilateral vagotomy at the cervical level in the dog did not affect acid secretion, when the separation was at the level of the diaphragm, insulin-stimulated acid secretion was reduced by 50% [6]. Furthermore, unilateral vagotomy has significantly reduced basal secretion and the acid response to stimulation by pentagastrin, histamine, and insulin in the ferret PI. No comparable data concerning the effect of unilateral vagotomy in man are available. During the course of simple or extended pneumonectomy for carcinoma of the lung, it is occasionally necessary to cut a vagal trunk to insure complete lymphadenectomy. This prompted the study of the acid response to histamine stimulation in patients undergoing a thoracotomy for carcinoma of the lung.