The Effect of Selective Proximal Vagotomy on the Secretion of Pepsin and the Serum Level of Group 1 Pepsinogen in Peptic Ulcer Patients

Toshiro Yamamoto

Second Department of Surgery, Yokohama City University School of Medicine

The effect of insulin-induced hypoglycemia on serum group I pepsinogen (PGI) levels, gastric H and pepsin sectetion was studied before and after selective proximal vagotomy (SPV) in 27 duodenal ulcer and gastric ulcer patients. The gastric H and depsin output decreased significantly after SPV, and it was more marked in duodenal ulcer patients than in gastric ulcer patients. The basal serum PGI levels in the patients with duodenal ulcers and gastric ulcers were 83.9 and 76.4 ng/ml, respectively, which were significantly higher than the control levels (48.5 g/ml). After SPV, the basal serum PGI level decreased significantly in duodenal ulcer patients, but it was unchanged in gastric ulcer patients. In duodenal ulcer patients, insulin-induced hypoglycemia caused a significant increase in the serum PGI level, but the increase did not occur after SPV. In gastric ulcer patients, no increase in serum PGI levels after insulin administration was observed before or after SPV. In peptic ulcer patients, the synthesis and transport of pepsinogen into the blood stream and gastric lumen is activated by vagal stimulation. The activity seems more pronounced in duodenal ulcer patients.

Key words
serum group I pepsinogen, pepsin, selective proximal vagotomy, peptic ulcer

Reprint requests
Toshiro Yamamoto Second Department of Surgery, Yokohoma City University of Medicine
3-46 Urafune, Yokohama, 232 JAPAN

Accepted
April 11, 1990

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