title: Gastric acid secretion and risk of recurrence of duodenal ulcer within six to eight years after truncal vagotomy and drainage.
abstract: The value of insulin and augmented histamine tests in predicting recurrence of duodenal ulcer within six to eight years after truncal vagotomy and drainage was assessed in a series of 500 consecutively and electively operated patients. Criteria of recurrence were established by a discriminative analysis of gastric acid secretion parameters. Recurrence was predicted with a probability of about 75% in patients with dyspepsia, the proportion between recurrences and dyspeptic nonrecurrences being 1:1. The discriminatory ability of the insulin test was no better than that of the postoperative histamine test. Men with a preoperative PAO > 46.1 m-equiv/h had a risk of recurrence of 21%, women with a PAO > 41.5 m-equiv/h, 28%. Below these levels the risk was 5 and 1% respectively, demonstrating that recurrence after vagotomy is related to the number of parietal cells before vagotomy. A rationale is provided for antrectomy and vagotomy in duodenal ulcer patients with a high number of parietal cells.
mesh_terms: D004322:Drainage; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005750:Gastric Juice / Q000378:metabolism*; D006632:Histamine; D006801:Humans; D007328:Insulin; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D012008:Recurrence; D012636:Secretory Rate; D012737:Sex Factors; D013997:Time Factors; D014628:Vagotomy / Q000379:methods
chemical_list: D007328:Insulin; D006632:Histamine