The Effect of Parietal Cell Vagotomy and Selective Vagotomy with Pyloroplasty on Gastric Emptying of a Solid Meal

Abstract

A new technique is described whereby gastric emptying of a ⁵¹Cr-labelled solid meal (hamburger, vegetables, potatoes) was measured by way of a movable NaJ(T 1) detector. The technique allowed separate measurements over the proximal and the distal part of the stomach. Seven volunteers took part in a study which revealed good correlation between two individual consecutive tests. Eight patients who took part in a controlled randomized series of parietal cell vagotomy (PCV) versus total gastric selective vagotomy and pyloroplasty (SV+P) underwent the test preoperatively and 6 to 8 months postoperatively. Following both operations gastric emptying was retarded. The time taken for the amount of meal remaining in the stomach to be reduced to 75, 50 and 25% respectively was significantly longer postoperatively than before surgery, but there were no differences in this respect between PCV and SV+P. The retardation of gastric emptying of solids was in contrast to the emptying of 10% glucose solution, which in the same series of patients was found to be accelerated. Following PCV there was a change in the distribution of the meal within the stomach immediately after the intake of the meal: a larger part of the meal was found in the proximal stomach postoperatively than before operation. There was no significant change in this intragastric distribution of the meal after SV+P.

Key-words:

• Gastric emptying
• stomach
• vagotomy, parietal cell
• vagotomy, selective