The effect of parietal cell vagotomy and selective vagotomy with pyloroplasty on gastric acid secretion. A prospective randomized study.
The insulin- and pentagastrin-stimulated gastric acid secretion was studied before and 1 week, 1 month, 6 months and 1 year after parietal cell vagotomy (PCV) and selective vagotomy with pyloroplasty (SV + P) in 50 patients who took part in a consecutive randomized trial. The randomization and the operations were performed in such a way that the extent of the denervation of the proximal stomach was identical in the two groups. Basal acid output and the insulin-stimulated acid secretion were significantly increased from 1 month to 1 year after PCV, while there was no such increase after SV + P. There was no change of the pentagastrin-stimulated acid secretion (PAOP) from 6 to 12 months in either groups. One year postoperatively PAOP was significantly greater after PCV than after SV + P. The results are compatible with vagal reinnervation after PCV and support the assumption of a sprouting from the innervated gastric antrum.
D000328:Adult; D002986:Clinical Trials as Topic; D004381:Duodenal Ulcer / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005750:Gastric Juice / Q000378:metabolism*; D005753:Gastric Mucosa / Q000166:cytology; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin / Q000494:pharmacology; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000601:surgery*; D012636:Secretory Rate / Q000187:drug effects; D014628:Vagotomy
D007328:Insulin; D010418:Pentagastrin