PATHOPHYRIOLOGICAL STUDIES ON POSTOPERATIVE PEPTIC ULCER

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The elucidation of the pathophysiology of peptic ulcer during recent years has resulted in a decrease in the incidence of postoperative peptic ulcer, but it has not yet been totally eliminated.For the purpose of preventing postoperative peptic ulcer, the authors perfurmed a pathyphysiological study of the condition from the standpoint of endo-exocrine functions by classifying the cases into three groups: Group I: Those who has received total resection of the pyloric gland, Group II: Those in whom the pyloric gland was retained, Group III: Those in whom the pyloric antrum was retained following the Billroth II operation. The findings were as followl: (1) In patients who underwent operation for duodenal ulcer and whose postoperative MAO value was greater than 1OmEq, the risk for recurrence was great. (2) In Group III, the B. G (basal gastrin level) and I-IGR (integrated gastrin response to insulin hypoglycemia stimulation) were both significantly higher than those in the other two groups, but the IGR was inhibited by the administration of secretin. (3) Group II revealed slightly greater response to T-IGR (meat extract stimulation) and C-IGR (calcium stimulation) than Group I, but the differences were not statistically significant.
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