Effect of vagotomy on the gastric secretion of acid chloride and pepsin in response to an antral stimulus and to insulin and maximal histamine stimulation.

Abstract

In this investigation the secretory response of the stomach to an antral stimulus followed by insulin and then histamine stimulation before and after vagotomy has been estimated in order to determine: (1) the effect of vagotomy on 'endogenous' gastric secretion resulting from antral stimulation compared with its effect on 'exogenous' secretion following insulin and histamine injections; (2) the effect of vagotomy on pepsin secretion compared with its effect on acid secretion; (3) the effect of vagotomy on total chloride secretion; and (4) whether after selective vagotomy any vagal innervation may reach the stomach via the coeliac plexus and greater curve resulting in a greater response to stimuli than that obtained after total vagotomy. METHODIt was not possible to use a continuous aspiration technique because, in order to determine the antral response, it was necessary that the antrum should be stimulated by a constant amount of the stimulating fluid for a constant time. Instead the dye dilution technique, as described by Brooks, Erskine, Gephart, Swaim, and Moore (1950), was used. At the beginning of every 10 minutes 100 ml of fluid containing phenol red (7 mg/l.) was injected into the stomach and the stomach was completely emptied by aspiration at the end of the 10-minute period. From the concentration of the dye in the aspirate it was possible to calculate both the volume of juice secreted and also the amount that had emptied from the stomach. It was then possible to calculate the actual concentration and quantity of acid, chloride, and pepsin that had been secreted during the period.Both sodium bicarbonate and peptone were used as antral stimulants because there is evidence that these act on the antral mucosa in different ways (Celestin, 1966). The effect of peptone is abolished by Lignocaine solution 3 % whereas the effect of sodium bicarbonate is unaltered, suggesting that peptone acts through neuroreceptors and sodium bicarbonate acts directly on the mucosal cells.

Effects of an Oral Glucose Load on Plasma Neurotransmitters in Humans: Involvement of REM Sleep?

“…Insulin likewise activates central serotonerIt is a known fact that the administration of either glu-gic and parasympathetic systems [3,4], Nonetheless, how cose or insulin increases plasma noradrenaline (NA) in these centrally induced effects reflect on plasma neuro normal humans. This effect is secondary to the stimula-transmitter levels is still unknown.…”

Results of proximal gastric vagotomy over 1–5 years in a district general hospital

“…On the other hand, other authors (Holt and Lythgoe, 1961;Clark et al, 1964) found preoperative acid studies to have no prognostic significance. Tovey et al (1968) found the biggest falls in M A 0 after truncal and selective vagotomy in those patients with the highest preoperative acid levels. Johnston et al (1975) have suggested that PGV alone is sufficient even for hypersecretors (MA0 more than 50 mmol/h in men) so long as incomplete vagotomy can be avoided.…”

Antral function in duodenal ulcer

“…The ratio of 'neutral' chloride concentration to total chloride concentration showed a marked fall with peptone stimulation and a lesser fall with maximal histamine stimulation (Table 3). It is interesting to note that after vagotomy the fall in acid concentration was accompanied by a big rise in 'neutral' chloride concentration (Tovey, 1968). …”