The physiology of postvagotomy duodenal ulcer healing: a prostaglandin connection

This study evaluated the type and mode of action exerted by truncal vagotomy on mucosal prostaglandin content in the rat. Ninety-six rats were equally divided into sham-operated, vagotomy, atropine-treated, and cimetidine-treated groups. Each group was subdivided into stressed (cold-restraint) and nonstressed cells. Gastric mucosal injury was graded, and duodenal mucosa was processed for determination of prostaglandin content. Results included: (1) significant increases in duodenal mucosal prostaglandins in all experimental groups compared with sham-operated controls, (2) decreases in duodenal mucosal prostaglandin content associated with stress in all groups, and (3) significantly less gastric mucosal injury in all stressed, experimentally treated rats compared with sham-operated animals. These results demonstrate that attenuation of gastric acid-secretion, achieved either surgically or pharmacologically and proved by decrease in stress gastric injury, is associated with an increase in the content of duodenal mucosal prostaglandins. Such augmentation of mucosal prostaglandins could account for, along with the direct acid-lowering effect of vagotomy, the success of truncal vagotomy in the surgical cure of duodenal ulcer disease.