Serum Gastrin Levels before and after Vagotomy and Pyloroplasty or Vagotomy and Antrectomy

Abstract

Fasting serum gastrin concentrations and rates of basal and maximum gastric acid secretion were measured in patients with duodenal ulcer before and at least six months after either antrectomy with vagotomy or pyloroplasty with vagotomy. The mean serum gastrin level after antrectomy and vagotomy was substantially and significantly (p less than 0.001) reduced; this decrease was accompanied by more than 90 per cent reduction in both basal and stimulated acid secretion. In sharp contrast, although gastric acid secretion was reduced, no fall in fasting serum gastrin concentrations was observed after pyloroplasty with vagotomy. These results indicate that reductions in gastric acid secretion after vagal transaction, with pyloroplasty, cannot be interpreted as consequences of reductions in vagally stimulated gastrin release; more probable mechanisms include modification of the sensitivity of the parietal-cell mass to gastrin or interruption of more direct vagal effects on acid-secreting cells.