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

Abstract

Gastric emptying was measured with the double sampling technique of George in 48 patients, who were randomized for 2 different types of vagotomy, parietal cell vagotomy (PCV) and total gastric selective vagotomy (SV + P), respectively. The emptying tests were performed preoperatively, 6 and 12 months after surgery. As test meal was used 750 ml of 10% glucose solution (glucose monohydrate m.w. 198). The operative techniques in the 2 groups of patients were identical as regards the proximal gastric denervation. Both PCV and SV + P showed an increased emptying during the first 10 minutes after the instillation of the test meal as compared with the preoperative values both 6 and 12 months after surgery. The initial emptying was significantly faster after SV + P than following PCV. The final emptying time was unchanged after PCV but decreased following SV + P as compared with preoperatively.

A significantly slower initial emptying 12 months after SV + P as compared with 6 months after surgery was the only change in emptying with time after the 2 types of surgery. It is concluded that both PCV and SV + P cause a rapid initial emptying (initial 10 minutes) as compared with unoperated duodenal ulcer patients. The initial emptying was faster and the final emptying time was shorter after SV + P than after PCV. One year after SV + P there was a significantly slower gastric emptying rate during the initial 10 minutes compared with 6 months after operation, although it was more rapid than preoperatively. This change in the initial emptying rate could indicate a recovery of some of the receptive relaxation and a decrease in intragastric volume/pressure relationship.

Key-words:

• Duodenal ulcer
• gastric emptying
• vagotomy, parietal cell
• vagotomy, selective