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Intrinsic factor secretion after vagotomy.

D D Meikle, J Bull, S T Callender

    The British Journal of Surgery
    |November 1, 1977
    PubMed
    Summary
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    Vagotomy significantly reduces intrinsic factor (IF) secretion in chronic duodenal ulcer patients. This effect appears permanent and may worsen over time, suggesting vagotomy, not drainage, impacts IF output.

    Area of Science:

    • Gastroenterology
    • Surgical Research
    • Endocrinology

    Background:

    • Chronic duodenal ulcers often involve altered gastric secretion.
    • Intrinsic factor (IF) is crucial for vitamin B12 absorption.
    • Surgical interventions like vagotomy aim to reduce gastric acid but may affect other secretions.

    Purpose of the Study:

    • To quantify intrinsic factor (IF) output in patients with chronic duodenal ulcer.
    • To assess the impact of highly selective vagotomy versus truncal vagotomy with pyloroplasty on IF secretion.
    • To determine if vagotomy itself or the associated drainage procedure is responsible for changes in IF output.

    Main Methods:

    • Estimation of intrinsic factor (IF) output during basal and Histalog-stimulated gastric secretion.

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  • Patient cohorts included those with chronic duodenal ulcer before and after surgical treatment.
  • Comparison of IF secretion following highly selective vagotomy and truncal vagotomy with pyloroplasty.

    • Main Results:

    • Both highly selective vagotomy and truncal vagotomy with pyloroplasty significantly reduced IF secretion post-Histalog stimulation.
    • The effects of the two vagotomy procedures were virtually identical, implicating vagotomy itself.
    • A marked reduction in IF output during the second hour of stimulated secretion was observed, suggesting early preformed IF wash-out, persisting after vagotomy.

    Conclusions:

    • Vagotomy, irrespective of the specific technique (highly selective or truncal with pyloroplasty), is responsible for reduced intrinsic factor secretion.
    • The observed reduction in IF secretion appears to be a permanent feature, potentially worsening over time.
    • The drainage procedure (pyloroplasty) likely plays no significant role in the altered IF secretion post-vagotomy.