The 2DG-neutral red test for completeness of vagotomy.

Ever since vagotomy became an important part of modern peptic ulcer surgery, investigators have searched for a test that would reliably indicate the completeness of vagus nerve section. The insulin hypoglycemia test, originally advocated by Hollander [8], has remained the most widely utilized test for the completeness of vagotomy, but despite several modifications it’s reliability has been questioned in a number of reports [6, 13, 141. In addition, the Hollander test has only postoperative application and cannot be used intraoperatively . Two-deoxy-D-glucose (2DG) is a potent vagal stimulant, causing an increase in gastric acid secretion greater than that produced by insulin-induced hypoglycemia [4]. The remarkable safety and low incidence of side effects associated with 2DG have been fully investigated in other studies involving humans [4,9, 121. Neutral red is an azine dye that is secreted by the gastric parietal cells into the stomach lumen [l], but only in the presence of intact vagal innervation to the stomach [lo]. Neutral red has likewise been shown to be safe for human use [7]. The present study is an attempt to use 2DG and neutral red in combination as a test for completeness of vagotomy both intraoperatively and postoperatively.