Serum Gastrin Response to Insulin Hypoglycaemia: Studies after Parietal Cell Vagotomy and after Selective Gastric Vagotomy

Abstract

Korman, M. G., Hansky, J., Coupland, G. A. E. & Cumberland, V. H. 1973. Serum Gastrin Response to Insulin Hypoglycaemia: Studies after Parietal, Cell Vagotomy and after Selective Gastric Vagotomy. Scand. J. Gastroent. 8, 235-239.

Serum gastrin and gastric acidity in response to insulin hypoglycaemia have been compared in patients with duodenal ulcer after parietal cell vagotomy (PCV), selective gastric vagotomy (SV), and intragastric neutralization with bicarbonate. After PCV, serum gastrin rose from a basal level of 43 ± 1.6 pg/ml to a peak of 174 ± 3.6 pg/ml and acidity remained about the basal level of 14 ± 1.7 mEq/1. After SV, both serum gastrin and gastric acidity remained unchanged at 50 ± 2.9 pg/ml and 12 ± 2.4 mEq/1 respectively. In unoperated patients with concomitant intragastric neutralization, serum gastrin rose from 9 ± 1.6 pg/ml to a modified basal level of 49 ± 1.9 pg/ml and after insulin to a peak of 177 ± 6.5 pg/ml. This study has demonstrated that parietal cell vagotomy diminishes acid secretion without alteration in antral function; that intact vagal innervation to the antrum is necessary for the release of gastrin in response to insulin hypoglycaemia, and that the physiological effects of PCV can be simulated by achieving intragastric neutralization in the unoperated patient with duodenal ulcer.

Key-words::

• Gastrin
• insulin hypoglycaemia
• parietal cell vagotomy
• radio-immunoassay
• vagus