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Acid secretory response in the late follow-up of proximal gastric vagotomy for duodenal ulcer without Helicobacter pylori eradication.
Hepatogastroenterology. 1999 Jan-Feb; 46(25):240-4.H

Abstract

BACKGROUND/AIMS

The profile of acid secretory responses was studied in 20 patients who had had proximal gastric vagotomy (PGV) surgery performed 11-22 years previously in order to treat duodenal ulcers (DU). The presence of Helicobacter pylori was detected in all of the patients.

METHODOLOGY

The recurrence of DU was diagnosed in 10 patients and the other 10 remained without recurrence during the follow-up period. The control groups included 10 DU patients with refractory responses to H2 receptor antagonists and 10 "normal" subjects. Both control groups had untreated Helicobacter pylori infection. Measures of 1) basal acid output, 2) acid output for 30 min under continuous i.v. infusion of 0.2 ug/kg/h of pentagastrin acid, and 3) the response for 30 and 60 min after starting a sham feeding, modified by the "chew and spit" technique under simultaneous i.v. infusion of 0.2 ug/kg/h of pentagastrin were performed. Serum gastrin was measured during fasting and at sham feeding. The densities of the gastrin cells of antrum and duodenum were estimated by morphometric counting.

RESULTS

Both basal output and acid response to sham feeding plus pentagastrin infusion were higher in the DU controls and DU recurrence patients. The response to pentagastrin infusion did not show any discriminant value. Fasting serum gastrin values increased after PGV, either with or without DU recurrence. Gastrin cell hyperplasia was not demonstrated in any of these groups.

CONCLUSIONS

The secretory profile of patients with both late DU recurrence after PGV and Helicobacter pylori infection lies between DU patients refractory to the H2 receptor antagonist approach and those free of DU recurrence after PGV--both of them with current Helicobacter pylori infection. The characteristic pattern of late DU recurrence after PGV and untreated Helicobacter infection is that of increased basal acid output and higher acid secretion responsiveness to sham feeding plus pentagastrin in the presence of higher serum levels of gastrin.

Authors+Show Affiliations

Department of Gastroenterology, University of Sao Paulo, Hospital das Clinicas, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10228800

Citation

Lopasso, F P., et al. "Acid Secretory Response in the Late Follow-up of Proximal Gastric Vagotomy for Duodenal Ulcer Without Helicobacter Pylori Eradication." Hepato-gastroenterology, vol. 46, no. 25, 1999, pp. 240-4.
Lopasso FP, Rodrigues JG, Alves VA, et al. Acid secretory response in the late follow-up of proximal gastric vagotomy for duodenal ulcer without Helicobacter pylori eradication. Hepatogastroenterology. 1999;46(25):240-4.
Lopasso, F. P., Rodrigues, J. G., Alves, V. A., Iriya, K., Sesso, A., Laudanna, A. A., & Pinotti, H. W. (1999). Acid secretory response in the late follow-up of proximal gastric vagotomy for duodenal ulcer without Helicobacter pylori eradication. Hepato-gastroenterology, 46(25), 240-4.
Lopasso FP, et al. Acid Secretory Response in the Late Follow-up of Proximal Gastric Vagotomy for Duodenal Ulcer Without Helicobacter Pylori Eradication. Hepatogastroenterology. 1999 Jan-Feb;46(25):240-4. PubMed PMID: 10228800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acid secretory response in the late follow-up of proximal gastric vagotomy for duodenal ulcer without Helicobacter pylori eradication. AU - Lopasso,F P, AU - Rodrigues,J G, AU - Alves,V A, AU - Iriya,K, AU - Sesso,A, AU - Laudanna,A A, AU - Pinotti,H W, PY - 1999/5/6/pubmed PY - 1999/5/6/medline PY - 1999/5/6/entrez SP - 240 EP - 4 JF - Hepato-gastroenterology JO - Hepatogastroenterology VL - 46 IS - 25 N2 - BACKGROUND/AIMS: The profile of acid secretory responses was studied in 20 patients who had had proximal gastric vagotomy (PGV) surgery performed 11-22 years previously in order to treat duodenal ulcers (DU). The presence of Helicobacter pylori was detected in all of the patients. METHODOLOGY: The recurrence of DU was diagnosed in 10 patients and the other 10 remained without recurrence during the follow-up period. The control groups included 10 DU patients with refractory responses to H2 receptor antagonists and 10 "normal" subjects. Both control groups had untreated Helicobacter pylori infection. Measures of 1) basal acid output, 2) acid output for 30 min under continuous i.v. infusion of 0.2 ug/kg/h of pentagastrin acid, and 3) the response for 30 and 60 min after starting a sham feeding, modified by the "chew and spit" technique under simultaneous i.v. infusion of 0.2 ug/kg/h of pentagastrin were performed. Serum gastrin was measured during fasting and at sham feeding. The densities of the gastrin cells of antrum and duodenum were estimated by morphometric counting. RESULTS: Both basal output and acid response to sham feeding plus pentagastrin infusion were higher in the DU controls and DU recurrence patients. The response to pentagastrin infusion did not show any discriminant value. Fasting serum gastrin values increased after PGV, either with or without DU recurrence. Gastrin cell hyperplasia was not demonstrated in any of these groups. CONCLUSIONS: The secretory profile of patients with both late DU recurrence after PGV and Helicobacter pylori infection lies between DU patients refractory to the H2 receptor antagonist approach and those free of DU recurrence after PGV--both of them with current Helicobacter pylori infection. The characteristic pattern of late DU recurrence after PGV and untreated Helicobacter infection is that of increased basal acid output and higher acid secretion responsiveness to sham feeding plus pentagastrin in the presence of higher serum levels of gastrin. SN - 0172-6390 UR - https://www.unboundmedicine.com/medline/citation/10228800/Acid_secretory_response_in_the_late_follow_up_of_proximal_gastric_vagotomy_for_duodenal_ulcer_without_Helicobacter_pylori_eradication_ DB - PRIME DP - Unbound Medicine ER -