THE EFFECT OF PARIETAL-CELL VAGOTOMY ON GASTROESOPHAGEAL FUNCTION IN DUODENAL-ULCER PATIENTS

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 16  (1) , 97-102
Abstract
By means of a previously described method, the gastroesophageal region of duodenal ulcer patients was examined before and 3 mo. after parietal cell vagotomy. Postoperatively, the patients had fewer symptoms of gastroesophageal reflux. The intragastric acid secretion was significantly reduced. In spite of this the esophagus function tests used to evaluate the gastroesophageal region.sbd.basal gastroesophageal sphincter pressure, acid perfusion test, acid clearing test and intensity of acid gastroesophageal reflux measured by automatic integration of the pH variations as a function of time in arbitrarily chosen pH intervals during 12 h together with peristaltic activity in the esophagus.sbd.were unchanged. The total number of reflux episodes was unaltered, but a significant change took place postoperatively in the distribution of the reflux episodes, in the direction of reflux episodes of higher pH. A comparison preoperatively during cimetidine treatment and postoperatively showed an increase in gastroesophageal sphincter pressure and a reduced intensity of acid gastroesophageal reflux during cimetidine treatment. Parietal cell vagotomy apparently does not affect the gastroesophageal sphincter pressure, esophageal peristaltic activity or frequency of acid gastroesophageal reflux. The reduction in intragastric acid secretion causes reflux episodes of higher pH and this in connection with healing of the ulcer explains the improvement in the symptoms of the patients.