Ulcer risk in a duodeno-gastric antireflux operation in dogs

Duodenogastric reflux is a possible pathogenetic mechanism in some type I gastric ulcers. An antireflux operation is therefore a logical procedure but involves the risk of marginal ulceration. To examine this risk, the following study was performed: 18 dogs were divided into 3 groups of 6. One group had an antireflux operation performed (AR), one had AR plus parietal cell vagotomy (AR + PCV), and the third was a control group that was given daily injections of 40 mg repository histamine. All control dogs developed ulcers after 7-84 days, mean 37 days, of histamine. Three dogs in the AR group developed ulcers spontaneously 55-92 days postoperatively, whereas none of the AR + PCV group developed ulcers spontaneously 72-108 days postoperatively. After histamine injection two of the remaining three AR dogs developed ulcers after 3-4 days of stimulation, and three of the six AR + PCV dogs developed ulcers after 4-5 days of stimulation. It is concluded that the AR operation is heavily ulcer-prone and that PCV does not protect sufficiently against ulceration.