Is re-communication of vagal branches responsible for the recurrence of duodenal ulceration after proximal gastric vagotomy? A study in the rat.
This study was carried out in the rat to examine whether preventing the re-communication of vagal fibres with their distal stumps after proximal gastric vagotomy (PGV), by placing a patch against the bare area of lesser curvature, impairs the return of gastric secretory patterns to their pre-operative levels and reduces the incidence of duodenal ulceration. PGV alone or with a patch significantly depressed the basal acid output. Administration of insulin (1 unit/kg i.p.) failed to stimulate this output. Two years later, the basal acid output of PGV was significantly (p < 0.05) higher than that of PGV with a patch (7.8 +/- 0.2 vs 3.7 +/- 0.3 mumol, mean +/- SEM), but significantly (p < 0.01) lower than that of the control animals (7.8 +/- 0.2 vs 14.2 +/- 0.8 mumol, mean +/- SEM). Insulin did not stimulate the acid output of PGV with a patch, but significantly (p < 0.001) stimulated the PGV acid output (7.8 +/- 0.2 vs 28.9 +/- 0.6 mumol, mean +/- SEM). This stimulation was significantly (p < 0.001) less than that noted in the control animals. PGV alone or with a patch equally prevented acid stimulation and production of duodenal ulceration by the infusion of pentagastrin (4 micrograms/kg/min) and carbachol (0.8 microgram/kg/min) for 24 hours. Two years later, these secretagogues significantly (p < 0.001) stimulated acid secretion in the PGV group relative to control values (24.1 +/- 2.3 vs 13.9 +/- 0.5 mumol, mean +/- SEM) and produced duodenal ulceration in 19% of the animals.(ABSTRACT TRUNCATED AT 250 WORDS)
Salim
A S
AS
University Department of Surgery, Royal Infirmary, Glasgow, UK.
D000818:Animals; D004381:Duodenal Ulcer / Q000517:prevention & control*; D005744:Gastric Acid / Q000378:metabolism*; D008297:Male; D009416:Nerve Regeneration; D051381:Rats; D017207:Rats, Sprague-Dawley; D014629:Vagotomy, Proximal Gastric; D014630:Vagus Nerve / Q000502:physiology*