Plasma Cholecystokinin Response to a Liquid Fat Meal in Vagotomized Patients

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Abstract
Since previous studies have suggested that in patients with truncal vagotomy (TV) the plasma cholecystokinin (CCK) secretion in response to nutrients is impaired, the plasma CCK response to a liquid fat meal (250 ml 20% intralipid) was measured in 6 patients with TV and pyloroplasty. The results were compared with those obtained in 8 normal subjects, 6 patients with duodenal ulcer, and 8 patients with highly selective vagotomy (HSV). Plasma CCK concentrations were measured by a sensitive and specific radioimmunoasay employing antibody T204 directed against the sulfated tyrosine region of CCK. Basal plasma CCK concentrations were not significantly different among the 4 groups studied (2.1 .+-. 0.4 pmol/l in normal subjects, 2.8 .+-. 0.5 pmol/l in duodenal ulcer patients, 3.1 .+-. 0.5 pmol/l in patients with TV, and 2.7 .+-. 0.5 pmol/l in patients with HSV). The increments in plasma CCK after ingestion of the fat meal in patients with TV (15.7 .+-. 3.1 pmol/l) and HSV (14.9 .+-. 1.6 pmol/l) were significantly higher (P < 0.01) than those in normal subjects (4.8 .+-. 0.9 pmol/l) and in patients with duodenal ulcer (5.5 .+-. 0.6 pmol/l). Similarly, the integrated plasma CCK secretions in patients with TV (554 .+-. 139 pmol/l, 120 min) and in patients with HSV (876 .+-. 132 pmol/l, 120 min) were significantly increased (P < 0.05) compared to those in normal subjects (187 .+-. 29 pmol/l, 120 min) and in patients with duodenal ulcer (264 .+-. 35 pmol/l, 120 min). Patients with TV and HSV show an increased plasma CCK secretion in response to a liquid test meal.