Effect of Proximal Gastric Vagotomy

Methods We calculated gastric HCO3 and H+ secretion, as well as nonparietal and parietal volume secretion, in 15 duodenal ulcer patients who had previously undergone successful proximal gastric vagotomy, 15 unoperated duodenal ulcer patients, and 15 normal control subjects. Basal HCO3secretion was not significantly altered after vagotomy, while basal H+ secretion, parietal volume and nonparietal volume secretion were reduced significantly. Intravenous gastrin-17 infusion increased H+, parietal volume and nonparietal volume secretion significantly in all three groups. In contrast, gastrin-17 infusion reduced gastric HCO3 secretion by 50% in both unoperated ulcer patients and normal subjects (P < 0.05). Gastrin-17 infusion did not inhibit gastric HCO3 secretion after vagotomy. In fact, mean gastric HCO3 secretion increased to a nearly significant extent in response to gastrin (P = 0.06). These findings indicate that gastrin inhibits gastric HCO3 secretion in humans and that the gastrin-induced reduction in gastric HCO3 secretion is dependent upon intact vagal innervation to the oxyntic mucosa.