Bile acid and lysolecithin concentrations in the stomach of patients with gastric ulcer: Before operation and after treatment by highly selective vagotomy, Billroth I partial gastrectomy and truncal vagotomy and pyloroplasty

Abstract

Bile acid and lysolecithin concentrations in the stomach were measured in normal subjects and in patients with gastric ulcer (GU) before operation and more than 1 year after highly selective vagotomy, Billroth I partial gastrectomy (PG) and truncal vagotomy and pyloroplasty. Before operation, patients with GU had significantly (P less than 0.001) higher bile acid concentrations in the stomach than normal people. After highly selective vagotomy, bile acid concentrations were significantly lower than in preoperative GU patients and were also significantly lower than in patients after PG, but were still higher than in normal people. Postprandial and peak lysolecithin concentrations after highly selective vagotomy were significantly lower than after partial gastrectomy. The therapeutic effect of highly selective vagotomy in the surgical treatment of GU may be due not only to reduced acid-peptic 'attack' on the gastric mucosa, but also to reduced duodenogastric reflux of 'bile'.

Perforated gastric ulcer

“…Where there is either a long history of ulceration or simple closure is impossible, either because of the size or the situation of the ulcer, partial gastrectomy is the treatment of choice (Jordan et al, 1963;Skanstein & Hoisater, 1976;Playforth & MacMahon, 1978). Whilst highly selective vagotomy may be as effective as partial gastrectomy in the elective treatment of chronic gastric ulcer (Reid et al, 1982;Dewar et al, 1983), it is technically difficult in the presence of a perforated gastric ulcer. The average duration of symptoms in our patients undergoing partial gastrectomy was 5 y.…”

Phospholipase A2: Its Usefulness in Laboratory Diagnostics

“…520 Both bile acids 521 and lysolecithin produced by PLA 2 can cause gastric ulcers in experimental animals, 522,523 and higher concentrations of both agents have been reported in gastric patients compared with healthy controls. 524 Activities of PLA 2 and accumulation of lysophospholipids could be involved in mediating the mucosal injury caused by small intestinal ischemia. 525,526 PLA 2 inhibitors such as the antiprotozoal agent quinacrine and the antioxidant nordihydroguaiaretic acid, occurring in the resinous exudates of many plants, prevent mucosal damage associated with small intestinal ischemia in rats.…”

Novel approach to quantify duodenogastric reflux in healthy volunteers and in patients with type I gastric ulcer.

“…Postprandial Ten healthy volunteers (aged [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] years) were studied in the supine position. Six of these subjects were also examined in the upright position.…”