A secretory and histological study of the stomach before and after truncal vagotomy and pyloroplasty in duodenal ulcer patients

Abstract

In 10 patients with duodenal ulcer gastric secretion was studied after graded doses of pentagastrin before and 3 months after truncal vagotomy and pyloroplasty. In 6 patients carbacholine was also infused simultaneously with the greatest dose of pentagastrin after vagotomy. The histology of the gastric mucosa was studied in suction biopsies obtained from the corpus of the stomach before and 3 months after the operation. After truncal vagotomy with pyloroplasty the maximal pentagastrin-stimulated acid and pepsin secretion and the sensitivity of the parietal cells to pentagastrin were all reduced significantly. There was no significant increase in maximal pentagastrin-stimulated acid and pepsin secretion when carbacholine was added to pentagastrin. The average thickness of the gastric mucosa and the mean number of parietal cells per unit area of the stomach did not show any significant change, while the number of patients with deep gastritis increased significantly after vagotomy.