Gastric emptying and dumping after proximal gastric vagotomy

One hundred dumping provocation tests were performed on patients who had had proximal gastric vagotomy without drainage in the pre- and postoperative period. Other than monitoring the symptoms of dumping on test, various other objective criteria, i.e., plasma volume fall, gastric emptying, and blood sugar changes were also measured simultaneously. Whether dumping was assessed clinically or on test, it seemed to be equally prevalent after proximal gastric vagotomy without drainage compared to vagotomy with drainage or partial gastrectomy. Although the pattern of gastric emptying after proximal gastric vagotomy alone was not significantly different from that before operation in those patients who had dumping symptoms on test, the half-life of the emptying were much faster. The plasma volume fall was also significantly greater and blood sugar was rise steeper in these patients. The objective measurements have not only helped in determining the incidence of dumping after proximal gastric vagotomy but have also proved to be of value in categorizing patients with doubtful symptoms and have given some insight into the etiopathogenesis of this syndrome.