Section of the vagal celiac branch in man reduces glucagon-stimulated insulin release

Abstract

The purpose of this study was to determine whether section of the celiac branch of the vagus nerve in man affects the insulin response to intravenous glucagon injection. Patients who received a subtotal gastrectomy with lymph node dissection for gastric carcinoma were divided into two groups: the celiac-preserved group (n = 16) and the celiac-sectioned group (n = 13). The hepatic branches of the vagus were preserved in both groups. The glucagon test was performed twice in each patient during the operation; before and after manipulation of the celiac branch. Blood samples were collected just before and 6 min after the injection. No difference in the mean increases in blood glucose, insulin and C-peptide levels were seen between the two groups before the nerve manipulation. In the celiac-preserved group, the glucagon stimulated glucose-related C-peptide ratio (x 10(-3) was 0.5 +/- 0.7 before the nerve manipulation and 3.5 +/- 3.0 after it, a significant difference (p < 0.01). In the celiac-sectioned group, this increase was not observed, the ratio was 0.7 +/- 0.6 before the nerve manipulation and 0.8 +/- 3.4 after. These results indicate that the vagal celiac branch in man may also be involved in the control of pancreatic insulin release.