title: Prospective study of the effect of gastrectomy with and without bile reflux on serum pepsinogens.
abstract: In order to prospectively determine the effect of gastrectomy with or without enterogastric reflux on serum pepsinogen concentrations, serum pepsinogen A, serum pepsinogen C and the pepsinogen A:C ratio were measured before, and 10 days and 6, 15 and 24 months after 2/3-3/4 distal gastrectomy in peptic ulcer patients with primary Roux-en-Y diversion (n = 11) or Billroth II reconstruction (n = 11). Gastrectomy induced early decreases in serum pepsinogen A from 100 +/- 12 to 66 +/- 7 micrograms/l (p less than 0.05) and from 111 +/- 11 to 82 +/- 20 micrograms/l (p = 0.05), serum pepsinogen C from 49 +/- 6 to 29 +/- 5 micrograms/l (p less than 0.05) and from 54 +/- 9 to 40 +/- 11 micrograms/l (p = 0.10) in patients with Roux-en-Y and Billroth II gastrectomy, respectively, but did not influence the pepsinogen A:C ratios. Serum pepsinogen A and the pepsinogen A:C ratio continued to decrease 6 months after surgery but no further significant reductions were observed 15 and 24 months postoperatively. Serum pepsinogen C concentrations did not significantly change during postoperative follow-up. Analyses of variances of serum pepsinogen A and the pepsinogen A:C ratio showed that the type of operation had no significant effect on the postoperative course. It is concluded that gastrectomy leads to early decreases in serum pepsinogen A and pepsinogen C levels followed by progressive further reductions of serum pepsinogen A and the pepsinogen A:C ratio for a period of 6 months postoperatively. These postoperative changes of serum pepsinogens are not due to increased enterogastric biliary reflux.
authors.affiliation: Department of Gastroenterology and Hepatology, University Hospital, Leiden, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Biemond
authors.forename: P N
authors.initials: PN
authors.lastname: Rieu
authors.forename: J B
authors.initials: JB
authors.lastname: Jansen
authors.forename: H J
authors.initials: HJ
authors.lastname: Joosten
authors.forename: C B
authors.initials: CB
authors.lastname: Lamers
mesh_terms: D001284:Atrophy; D001655:Bile Reflux / Q000097:blood*; D001660:Biliary Tract Diseases / Q000097:blood*; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood*; D011184:Postoperative Period; D011446:Prospective Studies; D011863:Radioimmunoassay / Q000379:methods; D011897:Random Allocation; D013997:Time Factors
chemical_list: D010435:Pepsinogens