title: The acid secretory response to betazole and insulin hypoglycemia after selective proximal vagotomy for duodenal ulcer.
abstract: In order to assess the result of vagotomy an insulin test is usually performed postoperatively. The insulin test, however, is associated with troublesome side-effects and potentially dangerous. Also its prognostic value as regards ulcer recurrence is doubtful. In this follow-up study of 118 patients, who had selective proximal vagotomy (SPV) performed for duodenal ulcer between 1968 and 1971, the insulin test is compared with a postoperative betazole (Histalog) test. Both tests were carried out 1-3 months after SPV. The insulin tests were classified according to Hollander. For the betazole tests the following criteria were used: the test was classified as negative if the reduction in peak acid output (PAOB) exceeded 50% or if the postoperative PAOB-value was lower than 15 mmol/h irrespective of the preoperative value. Values outside these were considered positive. At the follow-up 5-9 years after surgery, a total of 17 recurrent ulcers were diagnosed. The sensitivity and the specificity - i.e. the percentage of patients with recurrent ulceration and positive criteria respectively patients without recurrent ulcer and negative criteria - were calculated for the tests. Thus, the sensitivity and specificity for the insulin tests were found to be 53% and 84% respectively and for the betazole tests 59% and 91% respectively. The difference is thus very small and it seems that a postoperative test with a non-vagal gastric stimulant gives as good prognostic information as an insulin test after selective proximal vagotomy. However, both tests give a low sensitivity (53% resp. 59%) and therefore the prognostic value regarding ulcer recurrence is doubtful.
mesh_terms: D000328:Adult; D001625:Betazole / Q000494:pharmacology*; D004381:Duodenal Ulcer / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000503:physiopathology; D007328:Insulin / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011720:Pyrazoles / Q000494:pharmacology*; D013268:Stimulation, Chemical; D013270:Stomach / Q000294:innervation; D014628:Vagotomy; D014629:Vagotomy, Proximal Gastric; D014630:Vagus Nerve / Q000187:drug effects
chemical_list: D007328:Insulin; D011720:Pyrazoles; D001625:Betazole