Prognostic value of the pentagastrin and insulin tests after proximal gastric vagotomy

A review was made of 72 patients 3--6 years after proximal gastric vagotomy without drainage operation for duodenal ulcer. To assess the prognostic value of gastric acid secretory analyses, the correlation between the clinical results and the pentagastrin and insulin tests made preoperatively and 2 months postoperatively was determined. The preoperative secretory analyses showed no such correlation. Comparing recurrences and non-recurrences, only the basal acid output 2 months postoperatively showed any discriminatory ability, 2 mmol/h representing the critical level. When clinically satisfactory and clinically unsatisfactory patients were compared, the insulin-stimulated acid output and peak acid concentration 0--45 min after stimulation, in addition to the basal acid concentration and output, had statistically significant discriminatory levels. There was no correlation between the clinical results and seven different criteria for positive insulin response.