Acid and gastrin levels after bombesin and calcium infusion in patients with incomplete antrectomy

Abstract

In 17 patients with postoperative recurrent peptic ulcer, incomplete antrectomy (I.A.) was found by endoscopic biopsies in 5. No evidence of I.A. was found in the remaining 12 patients. Gastric acid output and gastrin levels were measured in basal conditions and following a calcium I.V. infusion (4 mg/kg hr of Ca⁺⁺ over 4 hr) and a bombesin (BBS) I.V. infusion (15 ng/kg min over 90 min). Basal gastrin levels were significantly different in the two groups of patients: BBS infusion augmented significantly serum gastrin levels in all patients with I.A., while BBS infusion had no significant effect on serum gastrin levels in the group of patients wihtout I.A. Acid output following BBS infusion showed a pattern similar to the pattern seen for gastrin. Calcium infusion augmented gastric acid secretion and gastrin levels in the patients with I.A.; however, the response to calcium could not clearly separate in all instances patients with I.A. from patients without I.A. It is concluded that the “BBS infusion test” may be helpful in the diagnosis of I.A. in patients with postoperative peptic ulcer.