Effect of Highly Selective Vagotomy on Gastric Emptying, Gastric Acid Secretion, and Gastrin Release : An Early Postoperative Study in Duodenal Ulcer Patients

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In 12 duodenal ulcer patients, gastric emptying (GE) of a radiolabelled solid meal, gastric acid secretion, and gastrin release were examined before and during the early postoperative period (median 13.5 days) after a highly selective vagotomy (HSV). HSV significantly delayed GE; the median slope of GE curves (K) decreased from 11.86 to 6.52 min^<-1> ×10^<-3> (p<0.01). A significant inhibition of the late phase of GE was reflected by a diminution of the curve shape parameter (S) from a median of 1.41 to 0.98 (p<0.02). A profound impairment of GE after HSV was found in 4 of 12 patients (33%). HSV resulted in a 49% decrease in the basal acid output (6.9±1.0 before to 3.5±1.0 mmol・h^<-1> after HSV, and a 56% reduction in the pentagastrin-stimulated gastric acid secretion (31.1±5.1 before vs 13.8±2.4 mmol・h^<-1> after HSV (p<0.01). A significant increase in both the fasted serum gastrin (38.9±3.7 to 66.9±8.4 ng・l^<-1>, p<0.05) and the meal-stimulated gastrin release (AUC_<0-120>: 7179±440 to 11158±1062 ng・l^<-1> min, p<0.05) was observed after HSV.
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