Acid Response to Sham Feeding as a Test for Completeness of Vagotomy

Abstract

The reproducibility of acid responses to modified sham feeding by the chew-and-spit technique (PAO_sh) was investigated in 21 duodenal ulcer (DU) patients 8 to 14 days after vagotomy. Possible relationships between PAO_sh and the acid response to 0.2 U of insulin per kilogram body weight were examined (PAO_I) in 23 other DU patients 8 to 14 days after vagotomy. PAO_sh was reproducible to a high degree (P_Spearman <0.001, CV 2.9%), and a highly significant relationship was found between PAO_sh and PAO_I after vagotomy (P_Sp <0.001). PAO_sh and PAO_I were similar when PAO_I was low, whereas a highly incomplete vagotomy according to PAO_I was followed by a somewhat lower, but substantial, acid response to sham feeding. The relationship between PAO_sh and PAO_I permits the recommendation of modified sham feeding as a safe stimulant of acid secretion in quantitative testing of completeness of vagotomy.

Key-words:

• Gastric acid
• insulin test
• sham feeding
• vagotomy