[Problems in ulcer surgery after the introduction of H2-receptor antagonists].
Recently, antisecretory drugs such as H2-receptor antagonists (H2-RA) or proton pump inhibitor have been used for peptic ulcer patients widely in Japan. However, there are possibilities that long term administration of H2-RA might cause changes in intragastric environment. The present study was designed to clarify the changes of surgical treatment in Japan Surgical Society training hospitals, before and after introduction of H2-RA. Serum gastrin and antral G-cell number was measured after administration of H2-RA (1 mg/kg 14 days continuous infusion) in rat. Also, acid secretion and gastrin response stimulated by adrenalin (40 ng/kg.min) were measured in duodenal ulcer patients. 1) In the view of surgical treatment, elective operation highly decreased after the introduction of H2-receptor antagonists, and showed the increase of the rate of emergency operation up to 70%. 2) Hypergastrinemia and antral G cell hyperplasia were observed after administration of H2-RA in rats. 3) Acid secretion stimulated by adrenalin which is considered as antral G cell dependent, showed a higher response in H2-RA treated cases than in those untreated. 4) Antrectomy was carried out in 43.4% of the patients treated with H2-RA versus 18.9% to the patients untreated.
Second Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
H
H
Akimoto
H
H
Kashiwagi
A
A
Ito
Y
Y
Fukuchi
K
K
Kimura
T
T
Kashiwagi
T
T
Aoki
D000818:Animals; D002452:Cell Count; D015738:Famotidine / Q000009:adverse effects*; D005744:Gastric Acid / Q000378:metabolism; D005755:Gastrins / Q000097:blood; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D006965:Hyperplasia; D007399:Interphase; D008297:Male; D010437:Peptic Ulcer / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011706:Pyloric Antrum / Q000166:cytology / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar; D011795:Surveys and Questionnaires
D005755:Gastrins; D006635:Histamine H2 Antagonists; D015738:Famotidine