Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 81, ISSUE 4, P392-398, April 1977

Download started.

Ok

Effect of intraduodenal acid on the pre- and postvagotomy basal gastric secretion and gastrin

  • C.A. Linares
    Correspondence
    Reprint requests: C. A. Linares, M.D., Department of Surgery, University of Buenos Aires School of Medicine, Agüero 1540-5; Buenos Aires, Argentina.
    Affiliations
    From the Municipal Postgraduate School of Surgery, Department of Gastroenterology (Ward V), Argentina

    From the “Pabellón Modelo” Centre of Nuclear Medicine, Rawson Hospital, Buenos Aires, Argentina
    Search for articles by this author
  • C.A. Falasca
    Affiliations
    From the Municipal Postgraduate School of Surgery, Department of Gastroenterology (Ward V), Argentina

    From the “Pabellón Modelo” Centre of Nuclear Medicine, Rawson Hospital, Buenos Aires, Argentina
    Search for articles by this author
  • G.C. Sartorio
    Affiliations
    From the Municipal Postgraduate School of Surgery, Department of Gastroenterology (Ward V), Argentina

    From the “Pabellón Modelo” Centre of Nuclear Medicine, Rawson Hospital, Buenos Aires, Argentina
    Search for articles by this author
  • R.J. Soto
    Affiliations
    From the Municipal Postgraduate School of Surgery, Department of Gastroenterology (Ward V), Argentina

    From the “Pabellón Modelo” Centre of Nuclear Medicine, Rawson Hospital, Buenos Aires, Argentina
    Search for articles by this author
DOI:https://doi.org/10.5555/uri:pii:0039606077902811
Effect of intraduodenal acid on the pre- and postvagotomy basal gastric secretion and gastrin
Previous ArticleBile-fat relationships in gastric secretory inhibition and bile flow stimulation
Next ArticleMassive weight loss following jejunoileal bypass. I. Effects on pulmonary function
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Acid instillation into the duodenum inhibits basal and stimulated gastric secretion. In man vagotomy suppresses this secretory inhibition. It is postulated that such inhibition responds to a dual mechanism: an hormonal one (enterogastrone) and a nervous one (vagus nerve). This study showed that preoperative duodenal acidification of duodenal ulcer patients results in a decrease in basal gastric secretion and in gastrin levels. On the contrary, in patients submitted to vagal denervation—either through truncal division or highly selective vagotomy—duodenal acidification does not inhibit gastric secretion; however, a drop occurs in basal gastrin levels. An intact gastric vagal innervation therefore, seems necessary for the preservation of the sensitivity of the parietal cell to the effect of hormonal inhibitors, it being immaterial whether duodenal innervation is present or not, as that duodenal acidification provokes a significant fall in serum gastrin levels as determined by radioimmunoassay. This hormonal decrease produced by duodenal acidification can be explained by the inhibition of gastrin release from the antrum. Agreement is expressed with the opinion of other authors that highly selective vagotomy does not appear to carry any advantage over truncal section of the vagus nerves from the standpoint of the inhibitory mechanism of gastric secretion from the duodenum.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Andersson S.
        Inhibitory effects of hydrochloric acid in antrum and duodenum on gastric secretory responses to test meal in Pavlov and Heidenhain pouch dogs.
        Acta Physiol. Scand. 1960; 49: 231
        • Becker H.D.
        • Evans J.C.
        • Reeder D.D.
        • et al.
        Duodenal acidification and antral release of gastrin.
        Arch. Surg. 1974; 108: 205
        • Brooks A.M.
        • Grossman M.I.
        Effect of secretin and cholecystokinin on pentagastrin-stirrmlated gastric secretion in man.
        Gastroenterology. 1970; 59: 114
        • Davidson W.D.
        • Urushibara O.
        • Thompson J.C.
        Similarity of action of pentagastrin and pancreozymincholecystokinin on the isolated stomach and pancreas.
        in: ed. 2. Surg. Forum. 19. 1968: 227
        • Day J.J.
        • Webster D.I.
        The autoregulation of the gastric secretion.
        Am. J. Dig. Dis. 1935; 2: 527
        • Dinoso V.
        • Chey W.Y.
        • Lorber S.H.
        Effect of secretin and motor function of the upper gastrointestinal tract in man.
        Clin. Res. 1966; 14: 295
        • Dragstedt L.R.
        Role of the vagus nerves in the physiology of gastric secretion.
        Am. J. Surg. 1969; 117: 813
        • Dragstedt L.R.
        Duodenal inhibition of gastric secretion.
        Am. J. Surg. 1969; 117: 841
        • Gillespie I.E.
        • Grossman M.I.
        Inhibitory effect of secretin and cholecystokinin on Heidenhain pouch responses to gastrin extract and histamine.
        Gut. 1964; 5: 342
        • Greenlee H.B.
        • Longhi E.H.
        • Guerrero J.D.
        • et al.
        Inhibitory effect of pancreatic secretin on gastric secretion.
        Am. J. Physiol. 1957; 190: 396
        • Hansky M.B.
        • Soveny C.
        • Korman M.G.
        Effect of secretin on serum gastrin as measured by immunoassay.
        Gastroenterology. 1971; 61: 62
        • Itoh Z.
        • Takeuchi S.
        • Aizawa L.
        • et al.
        The negative feedback mechanism of gastric acid secretion: Significance of acid in the gastric juice in man and dog.
        Surgery. 1975; 77: 648
        • Johnson L.R.
        • Grossman M.I.
        Intestinal hormones as inhibitors of gastric secretion.
        Gastroenterology. 1971; 60: 120
        • Johnston D.
        • Duthie H.L.
        Inhibition of gastric secretion in the human stomach.
        Lancet. 1965; 2: 1032
        • Johnston D.
        • Duthie H.L.
        Effect of fat in the duodenum on gastric acid secretion before and after vagotomy in man.
        Scand. J. Gastroenterol. 1969; 4: 561
        • Johnston D.
        • Wilkinson A.R.
        Highly selective vagotomy without a drainage procedure in the treatment of duodenal ulcer.
        Br. J. Surg. 1970; 57: 289
        • Jordan Jr., P.H.
        • Peterson N.D.
        Effects of secretin upon gastric secretion.
        Ann. Surg. 1962; 156: 914
        • Konturek S.J.
        • Grossman M.I.
        Effect of perfusion of intestinal loops with acid, fat or dextrose on gastric secretion.
        Gastroenterology. 1965; 49: 481
        • Linares C.A.
        • Bordoli O.H.
        Inhibición duodenal de la secreción gástrica.
        Bol. Trab. Acad. Argent. Cirug. 1972; 56: 522
        • Lucas K.
        • Magee D.F.
        • Nakajima S.
        • et al.
        Pancreozymin-cholecystokinin, a physiological mediator of gastric secretory inhibition of duodenal origin.
        Experientia. 1968; 24: 570
        • Mazure P.A.
        • Cosen J.N.
        • Schraier M.
        Acción de algunas drogas sobre el pH duodenal.
        Acta Gastroenterol. Latinoam. 1970; 2: 1
        • Meyer J.H.
        • Way L.W.
        • Grossman M.I.
        Pancreatic bicarbonate response to various acids in duodenum of the dog.
        Am. J. Physiol. 1970; 219: 964
        • Nakajima S.
        • Magee D.F.
        Influences of duodenal acidification on acid and pepsin secretion of the stomach in dogs.
        Am. J. Physiol. 1970; 218: 545
        • Petersen H.
        The effect of secretin on the basal gastric acid secretion in man.
        Scand. J. Gastroenterol. 1969; 4: 609
        • Preshaw R.M.
        • Grossman M.I.
        Stimulation of pancreatic secretion by extracts of the pyloric gland area of the stomach.
        Gastroenterology. 1965; 48: 36
        • Shay H.
        • Gershon-Cohen J.
        • Fels A.A.
        A selfregulatory duodenal mechanism for gastric acid control and an explanation for the pathologic gastric physiology in uncomplicated duodenal ulcer.
        Am. J. Dig. Dis. 1942; 9: 124
        • Sokolov A.P.
        Secretory mechanisms of digestive glands. ed. 2. 1904 Thesis. Paul B. Hoeber, Inc., Medical Book Division of Harper & Row, Publishers, New York1950: 642 (St. Petersburg, quoted by Babkin, B. P.)
        • Thomas J.E.
        • Crider J.O.
        A quantitative study of acid in the intestine as a stimulus for the pancreas.
        Am. J. Physiol. 1940; 131: 349
        • Uvnäs B.
        Role of duodenum in inhibition of gastric secretion.
        Scand. J. Gastroenterol. 1971; 6: 113
        • Ward A.S.
        The effect of vagotomy on the inhibition of gastric secretion by intraduodenal acid.
        Br. J. Surg. 1974; 61: 698
        • Ward A.S.
        • Bloom S.R.
        The role of secretin in the inhibition of gastric secretion by intraduodenal acid.
        Gut. 1974; 15: 889
        • Woods L.P.
        Secretin inhibition of gastric hydrochloric acid in human beings.
        in: ed. 2. Surg. Forum. 16. 1965: 315
        • Wormsley K.G.
        Gastric response to secretin and pancreozymin in man.
        Scand. J. Gastroenterol. 1968; 3: 632
        • Wormsley K.G.
        Response to duodenal acidification in man. II. Effects on the gastric secretory response to pentagastrin.
        Scand. J. Gastroenterol. 1970; 5: 207

      Article info

      Publication history

      Accepted: May 14, 1976

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606077902811

      Copyright

      © 1977 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX