Use and abuse of gastric function tests by British and American gastric surgeons

The use of gastric function tests by American and British gastroenterologic surgeons in different clinical situations has been studied by questionnaire. Clinical practice on both sides of the Atlantic is generally similar. The major difference in the type of test employed is that pentagastrin cannot be used in clinical practice in the United States. Surgeons in the USA were much more liberal in their indications for gastric secretory tests than were their British counterparts. Significantly more tests were used by American surgeons, if x-ray evidence of duodenal or gastric ulcer existed, and to evaluate a post-gastrectomy patient, whether symptomatic or not. The British surgeonswere much less likely to allow the results of secretory tests to influence their surgical approach. The authors discuss indications for and the clinical value of gastric secretion tests and conclude that in most instances far too many tests are being employed.