Cholinergic inhibition and release of gastrin following insulin injection in duodenal ulcer before operation and after complete and incomplete vagotomy

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Abstract
In 50 duodenal ulcer patients acid and gastrin secretory responses were determined in the fasting state and after insulin hypoglycemia. Completeness of vagotomy was assessed by multiple criteria. In all three groups of patients studied, ie, the unoperated, the incomplete and the complete vagotomy groups, an initial gastrin inhibition was observed, the inhibition being minimal, moderate, and exaggerated, respectively. This inhibitory phase was followed by a significant rise in gastrin in the unoperated and the incomplete vagotomy groups, the rise being significantly higher in the latter. This rise was insignificant in those with complete vagotomy. The evidence suggests the presence of both an inhibitory and a releasing mechanism for gastrin release. The ratio of basal serum gastrin to postinsulin gastrin separates complete and incomplete vagotomy without overlap.