Gastritis duodenitis, and circulating levels of gastrin in duodenal ulcer before and after vagotomy.
Open Access
- 1 September 1976
- Vol. 17 (9), 719-728
- https://doi.org/10.1136/gut.17.9.719
Abstract
Biopsy specimens have been taken from five standard sites in the stomach and from the duodenal bulb in order to investigate the association of gastritis and duodenitis with duodenal ulcer. Twenty patients with chronic duodenal ulcer were investigated in this manner and in addition had gastric secretion tests and a radio-immune assay of serum gastrin under differing conditions. The patients were then treated either by a truncal vagotomy and pyloroplasty (TVP) or by a highly selective vagotomy without a drainage procedure (HSV). All the investigations were repeated three months postoperatively. Duodenal ulcer was usually associated with gastriitis, although this varied in extent and severity from patient to patient. In nearly all the patients, gastritis was present at the pyloric end of the stomach and along the lesser curve. In more than half of the patients, gastritis was also present in the body of the stomach but the fundus was usually spared. Chronic duodenitis was found in the duodenal bulb in all these patients. After vagotomy there was a marked increase in both the extent and severity of the proximal gastritis in both treatment groups but the distal gastritis remain almost unchanged. There was little change in the incidence of duodenitis after vagotomy but its severity was lessened. No correlation was found between the peak acid output (PAO) in response to Histalog and the severity of the gastritis or the duodenitis either before or after operation, with one exception. The postoperative PAO was significantly less in those patients who developed a severe proximal gastritis after vagotomy. No relationship was found between the severity of the distal gastritis and the levels of serum gastrin. No correlation was found between either the basal or peak acid output and the corresponding serum gastrin levels before or after vagotomy.Keywords
This publication has 18 references indexed in Scilit:
- The Histological Classification of Duodenitis in Fibreoptic Biopsy SpecimensDigestion, 1975
- PLASMA-GASTRIN AND ACID SECRETION IN PATIENTS WITH PEPTIC ULCERATIONThe Lancet, 1974
- The specificity of antibodies directed to porcine gastrinImmunochemistry, 1974
- Comparative Evaluation of Water Recovery Test and Fluoroscopic Screening in Positioning a Nasogastric Tube during Gastric Secretory StudiesBMJ, 1972
- The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimensJournal of Clinical Pathology, 1972
- STOMACH CANCER FOLLOWING GASTRIC SURGERY FOR BENIGN CONDITIONSThe Lancet, 1971
- Effect of Medical and Surgical Vagotomy on Intrinsic Factor SecretionBMJ, 1967
- GASTRIC SECRETORY PATTERNS BEFORE AND AFTER VAGOTOMYThe Lancet, 1966
- Aspects of Nutrition after Vagotomy and GastrojejunostomyBMJ, 1964
- Preparation of Iodine-131 Labelled Human Growth Hormone of High Specific ActivityNature, 1962