Influence of the Number of Parietal Cells on Risk of Recurrence after Truncal Vagotomy and Drainage for Duodenal Ulcer

Abstract

Relationships between pre- and postoperative augmented histamine test results and the risk of recurrence after truncal vagotomy and drainage for duodenal ulcer were demonstrated in 500 patients subjected to a complete follow-up. Men with a preoperative PAO ≥ 46.4 meq/h had a risk of recurrence of 14%, women with a PAO ≥ 42.2 meq/h, 28%. Below these levels the risk was 1.7 and 1.1% respectively. It was concluded that recurrence is not only caused by an incomplete vagotomy, since patients with a delayed positive Hollander response and recurrence had a higher parietal cell mass than those with a delayed positive Hollander response, but without recurrence. It is suggested that patients with duodenal ulcer and a high parietal cell mass (PAO ≥ 46.4 and 42.2) are subjected to antrectomy and vagotomy.

Key-words:

• Antrectomy
• augmented histamine test
• duodenal ulcer
• gastric acid secretion
• insulin test
• recurrence
• vagotomy