Recurrent Ulcer after Selective Proximal Vagotomy for Duodenal Ulcer

Yasumasa Kondoh, Kyoji Ogoshi, Masao Miyaji, Kunihiro Iwata, Shunsuke Hara, Tomoo Tajima, Toshio Mitomi

Department of Surgery, Tokai University School of Medicine

From 1978 through 1984, 31 patients underwent selective proximal vagotomy for a duodenal ulcer. All patients were tested for spontaneous gastric acid secretion for one hour as basal acid output (BAO), tetragastrin-stimulated gastric secretion, insulin-stimulated gastric secretion, fasting plasma gastrin, and integrated gastrin response to a test meal (T-IGR) and to insulin, before and one year after surgery. The cumulative recurrent rates were calculated by the Kaplan-Meier method. Nine of the patients (29.0%) developed recurrent ulcers and the lO-year cumulative recurrent rate was 31.7%. The tetragastrin-stimulated maximum acid output one year after surgery and the preoperative T-IGR in patients with recurrent ulcers were higher than those in patients without them. The patients with a preoperative BAO value over 4 mEq/h or a preoperative T-IGR value over 2 min·ng/ml had more recurrent ulcers than those with a BAO value less than 4 mEq/h or a T-IGR value less than 2 min·ng/ml. According to these results, the patients with high gastric secretion and high gastrin response to a test meal may develop recurrent ulcers.

Key words
recurrent Ulcer, selective proximal vagotomy, gastric acid secretion, gastrin, integrated gastrin response to a test meal

Reprint requests
Yasumasa Kondoh Department of Surgery, Tokai University School of Medicine
Boseidai, Isehara, 259-11 JAPAN

Accepted
May 8, 1991

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