Selective vagal effects on the intestinal phase of gastric secretion

Middleton, Michael D.; Kelly, Keith A.; Nyhus, Lloyd M.; Harkins, Henry N.

doi:10.1136/gut.6.3.296

Cited by 34 publications

(7 citation statements)

References 9 publications

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“…Stening and Grossman (1970) have shown that extragastric vagotomy in dogs increases the response of a Heidenhain pouch to pentagastrin but not to histamine. It has also been shown that this increases the spontaneous 24-hour acid output from vagally denervated Heidenhain pouches (Kelly, Nyhus, and flarkins, 1964;Landor, 1964;Middleton, Kelly, Nyhus, and Harkins, 1965). Further Middleton et al (1965) showed that dogs with denervated pouches, total gastrectomy, and truncal vagotomy increased pouch secretion in response to a meal as compared to the situation when the extragastric fibres were intact.…”

Section: Discussionmentioning

confidence: 98%

Serum gastrin in duodenal ulcer: Part III Influence of vagotomy and pylorectomy

Korman¹,

Hansky²,

Scott³

1972

Gut

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Part III Influence of vagotomy and pylorectomy SUMMARY Following truncal vagotomy and anterior pylorectomy for duodenal ulcer, fasting serum gastrin levels were higher at 84 ± 7.9 pg per ml than in unoperated patients with duodenal ulcer (16 ± 1.5 pg per ml). In response to a standard protein meal, the peak serum gastrin achieved in the vagotomized group was 259 ± 37.8 pg per ml at 75 minutes after ingestion, a much higher response than that obtained with a standard meal plus prior atropinization in the unoperated duodenal ulcer patients.These results suggest that truncal vagotomy allows release of gastrin which was previously inhibited with the vagi intact and the temporal characteristics of the response indicate that some of this gastrin is derived from an extragastric source. The results also exemplify the dependence of gastrin estimations as measured by this immunoassay on the acidity of the contents bathing the gastric antrum.

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Section: Discussionmentioning

confidence: 98%

Serum gastrin in duodenal ulcer: Part III Influence of vagotomy and pylorectomy

Korman¹,

Hansky²,

Scott³

1972

Gut

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“…This would be supported by our finding that the Heidenhain pouch secretion over a period of 24 hours on the standard dietary intake increased after intestinal denervation. Other investigators also have reported an increase in gastric secretion following extragastric vagotomy or posterior selective vagotomy (Landor, 1964;Kelly, Nyhus, and Harkins, 1964;Middleton, Kelly, Nyhus, and Harkins, 1965). A reduction in enterogastrone, however, would be expected to reduce the inhibition of both the gastric fistula and the Heidenhain pouch secretion.…”

Section: Discussionmentioning

confidence: 99%

The influence of mesenteric denervation on the inhibition of gastric secretion by fat in the intestine

Isaza¹,

Sugawara²,

Curt³

et al. 1971

Gut

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SUMMARY The inhibitory effect of fat in the upper small intestine was studied in dogs prepared with a Heidenhain pouch, gastric fistula, and jejunal fistula. Gastric secretion was stimulated by a constant intravenous infusion of pentagastrin, and emulsified olive oil was introduced into the jejunum. The small intestine of the dog was denervated by complete transection of the mesentery except for the superior mesenteric vessels. After intestinal denervation inhibition of the vagally innervated stomach was almost abolished while that in the Heidenhain pouch was unchanged. It is concluded that either autonomic innervation is important in the formation of enterogastrone or, more likely, that efferent inhibitory fibres in the vagus to the stomach act synergistically with enterogastrone.Pavlov (1910) in his classic monograph describes the experiments of Khizhin, Lobasov, and Sokolov, demonstrating that fat introduced into the duodenum reduces gastric secretion. This finding has been confirmed by many workers and has been attributed to a humoral mechanism, 'enterogastrone' (Kosaka and Lim, 1929-30). Subsequent work has indicated that the intestine plays a key role in inhibiting gastric function, both motor and secretory. This regulation is not accomplished by a single mechanism, but by many, including both autonomic nervous and endocrine mechanisms. The inhibitory effect of fat on gastric secretion cannot be fully accounted for by the known polypeptide hormones (Johnson and Grossman, 1969). The present experiment was undertaken to investigate the possibility that the autonomic nervous system might have a significant role in the 'enterogastrone' mechanism by which fat in the intestine inhibits gastric secretion. MethodFive mongrel dogs weighing 15 to 18 kg were prepared by a one-stage aseptic operative procedure.A Heidenhain (denervated fundic) pouch was constructed and drained to the exterior by a stainless steel Dragstedt cannula (Dragstedt, Haymond, and Ellis, 1933). A gastric fistula was then created in the remaining stomach by inserting a Thomas

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“…Shiina and Griffith (1969) suggested that since Heidenhain pouch acid secretion was more elevated after TV than after SV, hepatic and celiac vagi would have an inhibitory action against acid secretion. Landor (1964) , Kelly et al (1964) and Middleton et al (1965) demonstrated that acid secretion was markedly increased by extragastric vagotomy, viz., it was remarkably increased by hepatic and celiac vagotomy as well as by TV. Based on this fact, Walsh et al (1972) described that humoral factor, especially extragastric humoral factor , other than gastrin, would be disturbed by TV and extragastric vagotomy, i .e., because the serum gastrin response to feeding reached its peak level with short duration of the elevation in 30 to 90 nun after the vagotomy and the acid secretory response gradually elevated and the peak level was prolonged in long period, they speculated that there would exist unknown acid secretagogue other than gastrin in the humoral factor .…”

Section: Discussionmentioning

confidence: 99%