Effect of Vagotomy on lntragastric pH of Duodenal Ulcer Patients

Nobuo Omura, Hideyuki Kashiwagi, Yasunori Fukuchi, Keizo Kimura, Shinichiro Koga, Masamitsu Watanabe, Yoshio Ishibashi, Yutaka Suzuki, Toru Takaoka, Yusuke Moriya, Tetsuu Kin, Teruaki Aoki

Second Department of Surgery, The Jikei University School of Medicine

We determined the effect of selective proximal vagotomy (SPV) or selective vagotomy plus antrectomy (SVA) on the intragastric pH of 16 duodenal ulcer patients by continuous pH monitoring, and investigated the significance of the intragastric pH on duodenal ulcer relapse compared with healthy volunteers. Twelve healthy volunteers had an intragastric mean pH of 1.86±0.46, median pH of 1.46±0.30, and the greater than 3.0 pH units 12.0±7.5%. Preoperatively, the SPV group (8 patients) had an intragastric mean pH of 1.75±0.47, median pH of 1.46±0.31, and the greater than 3.0 pH units 9.1±8.8%. Postoperatively, these changed to 1.90±0.36, 1.44±0.28 and 12.0±7.9, respectively, with no significant difference. On the other hand, in the SVA group (8 patients) the values were 1.64±0.39, I.26±0.25, 6.2±4.2 before the operation and increased markedly to 3.79±1.40, 3.54±1.69, 61.4±33.7, respectively after the operation. Our results indicated that effects of SPV on intragastric pH were very little because the intragastric pH stayed the same that of healthy volunteers. However, SVA prevented ulcer relapse by continuous intragastric pH elevation under non-physiological pH conditions.

Key words
duodenal ulcer, selective proximal vagotomy, selective vagotomy plus antrectomy, intragastric pH monitoring

Reprint requests
Nobuo Omura Second Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi, Minatoku, Tokyo, 105 JAPAN

Accepted
October 13, 1993

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