Study on motor functions of antrum after highly selective vagotomy (HSV) plus mucosal antrectomy

To elucidate the effects of highly selective vagotomy plus mucosal antrectomy (HSV-MA) antral functions, eighteen dogs were randomly divided into control, HSV and HSV-MA group for determining gastric emptying, antral myoelectric activity and antral pressure. The tests were performed 4 months after operation in the HSV-MA and HSV group. By roentgenoscopy, the gastric and duodenal shape were normal, and gastric peristalsis was clearly seen in all the dogs in the three groups. The beginning and ending time of gastric emptying in the HSV-MA group were 5.0 +/- 0.06 minutes and 4.0 +/- 0.4 hours respectively, which were similar to those in the control and HSV group (P > 0.05). The frequency of antral myoelectric action potential in the HSV-MA group (3.11 +/- 0.65 cycles/minutes) was significantly lower than those in the control and HSV group (P < 0.05). Intramuscular injection of pentagastrin significantly increased the frequency of antral myoelectric action potential (P < 0.01) in all groups, and eliminated the difference among them before the injection. The antral pressure wave occurred immediately following the antral myoelectric action potential waves. The antral pressure values in the control and HSV-MA group were similar (P > 0.05), and were significantly lower than that in the HSV group (P < 0.05). Intramuscular injection of pentagastrin significantly increased the antral pressure (P < 0.001) in all groups and eliminated the difference among them before the injection. These evidences suggest that the motor function of the reconstructed antrum following HSV-MA nearly reached normal level despite a lower antral myoelectric frequency. Combined with other reports, HSV-MA has a good clinical prospect as an operation for the treatment of chronic duodenal ulcer.