Gastrin response to food in duodenal ulcer patients before and after selective or highly selective vagotomy

Abstract

The role of the vagus in the gastrin response to a steak meal was investigated in patients with duodenal ulcer. Thirty patients were studied before and after vagal denervation of the entire stomach (selective vagotomy and s pyloroplasty). Basal and stimulated gastrin concentrations in serum, as determined by radio-immunoassay, were higher postoperatively (87 pre-/III postopera-tively (basal)and 2431341 (peak) pglml). Thirty other patients were studied before and after denervation of the gastric body (highly selective vagotomy). Bnsnl and stimulated gastrin concentrations were also higher postoperatively in these patients (94/133 and 277/343 pg/ml respectively). The differences between the two groups were insignificant. Between individuals, gastrin responses varied markedly, but pre- and postoperative responses were positively related within the same subject. No differences were observed between patients with ‘positive’ or ‘negative’ Hollander responses to insulin. In 6 subjects studied 2 and 14 weeks postoperatively no difference was apparent between the two studies. It is concluded that antral branches of the vagi play only a minor role, if any, in the gastrin response to food.