Effect of Antrectomy, Vagotomy with Gastrojejunostomy, and Antrectomy with Vagotomy on the Spontaneous and Maximal Gastric Acid Output in Man

Gillespie, Iain; Clark, Douglas H.; Kay, A. W.; Tankel, H. I.

doi:10.1016/s0016-5085(60)80158-8

Cited by 77 publications

(18 citation statements)

References 6 publications

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confidence: 99%

“…We have previously reported the effect of vagotomy with gastrojejunostomy, antrectomy, and of antrectomy combined with vagotomy on human gastric secretion (Gillespie, Clark, Kay, and Tankel, 1960). More recently our interest has been focused on the effect of vagotomy and gastrojejunostomy on gastric secretion with a view to estimating the effect of the vagotomy.…”

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A Clinical and Statistical Study of the Effect of Gastrojejunostomy on Human Gastric Secretion

Tankel¹,

Gillespie²,

Clark³

et al. 1960

Gut

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From the Western Infirmary, Glasgow, and the Royal Infirmary, Sheffield By a statistical study using the Kay augmented histamine test it has been shown that performing a gastrojejunostomy has no fundamental effect on gastric secretion and that the post-operative differences are due entirely to reflux and/or loss through the stoma.We have previously reported the effect of vagotomy with gastrojejunostomy, antrectomy, and of antrectomy combined with vagotomy on human gastric secretion (Gillespie, Clark, Kay, and Tankel, 1960). More recently our interest has been focused on the effect of vagotomy and gastrojejunostomy on gastric secretion with a view to estimating the effect of the vagotomy. However, in comparing pre-operative and post-operative results, it is difficult to evaluate how much of the alterations in volume or acid output should be ascribed to the presence of the gastrojejunostomy alone.The literature on the effect of gastrojejunostomy on gastric secretion, which has been reviewed by Ivy, Grossman, and Bachrach (1950), is inconclusive. Some workers reported no effect on secretion, others a moderate reduction. Moreover, experiments were not performed in a readily comparable way nor were results given in such reproducible units as can be obtained from the augmented histamine test (Kay, 1953).We have again studied this problem from two points of view. First, we wished to record the effect of gastrojejunostomy on gastric secretion as judged by the volumes and total acid outputs of the spontaneous secretion and the augmented histamine response. Secondly, if any alteration did occur, it was clearly desirable to determine if this could be explained by alteration of the secretory activity of the parietal cells or simply by reflux or loss through the stoma. METHODMale patients with duodenal ulcer were selected for study. All had clinical and radiological evidence of *Present address: Department of Surgery, The Royal Infirmary, Sheffield, 6. pyloric stenosis and most were over 50 years of age, these two factors being felt to justify treatment by gastrojejunostomy alone. In severe stenosis the presence of undigested food occasionally rendered aspiration difficult. These patients were not included in the series, leaving 17 patients to be studied in detail.The posterior gastrojejunostomy was made with the stoma placed at the most dependent part of the greater curvature of the stomach.Augmented histamine tests as described by Kay (1953) were carried out twice pre-operatively and on two occasions seven to 10 days post-operatively. The patients were fasted overnight and care was taken in the placing of the intragastric tube so that the stomach could be completely emptied by continuous suction with an electric suction pump. The patency of the tube was verified at frequent intervals by the injection of a little air. Spontaneous secretion was measured over a period of one hour. The augmented histamine secretion was collected during the second and third 15-minute periods following the histamine injection, this half hour ...

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confidence: 99%

mentioning

confidence: 99%

A Clinical and Statistical Study of the Effect of Gastrojejunostomy on Human Gastric Secretion

Tankel¹,

Gillespie²,

Clark³

et al. 1960

Gut

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show abstract

“…The previous impression that complete vagotomy with a drainage procedure reduces the maximal histamine response by approximately 70 % (Gillespie, Clark, Kay, and Tankel, 1960;Gelb, Baronofsky, and Janowitz, 1961) is further confirmed by the mean reduction in augmented histamine response in those patients judged by all criteria to have negative responses to insulin. It is therefore believed that lesser degrees of reduction in the augmented histamine response may well be associated with incomplete vagal section.…”

Section: Discussionmentioning

confidence: 76%

An analysis of the insulin test after vagotomy using single and multiple criteria.

Gillespie¹,

Gillespie²,

Kay³

1968

Gut

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“…A very high incidence of achlorhydria is reported in other series (Palumbo and Sharpe, 1965). However, Gillespie, Clark, Kay, and Tankel (1960)found some free acid in each of five patients investigated by the augmented histamine test soon after antrectomy and vagotomy. Two of these patients were tested again some months later, when the secretion had declined to only 0 07 mEq.…”

Section: Discussionmentioning

confidence: 82%

Late results of antrectomy and vagotomy.

Dean¹,

Edwards²,

Munro³

1966

Gut

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Effect of Antrectomy, Vagotomy with Gastrojejunostomy, and Antrectomy with Vagotomy on the Spontaneous and Maximal Gastric Acid Output in Man

Cited by 77 publications

References 6 publications

A Clinical and Statistical Study of the Effect of Gastrojejunostomy on Human Gastric Secretion

A Clinical and Statistical Study of the Effect of Gastrojejunostomy on Human Gastric Secretion

An analysis of the insulin test after vagotomy using single and multiple criteria.

Late results of antrectomy and vagotomy.

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