[Vagotomy and serum gastrin levels (author's transl)]

Following selective proximal vagotomy (SPV) in duodenal ulcer patients basal acid output (BAO) and peak acid output (PAO) decrease by 79,3% and 41,8% respectively. Serum gastrin levels increase by 83% within the first five days after operation. Patients having had a SPV release evidently more gastrin after test meals as compared with the results before vagotomy. In consideration of the elevated praeoperative values insulin hypoglycaemia does not cause an augmented secretion of gastrin. There is no correlation between the fall in acid secretion and the increase in gastrin levels. Acidification of the gastric antrum (pH 2,0) did not influence the raised serum gastrin levels at the 10. day and one year after operation. There is a close correlation (r=0,94) between the percental increase in the basal gastrin concentration and the percental change of the vagal influence on the secretion of the parietal cell. It is postulated that together with the dissection of stimulating vagal fibres reaching the parietal cells other fibres are cut which cause an inhibition of gastrin release from the antral G-cells. Thus, the disinhibition of an oxyntopyloric reflex may account for the increase in serum gastrin levels after SPV.