Long Term Follow-up Study of Selective Vagotomy with Pyloroplasty -Physiological and Morphological Studies of Gastric Endo and Exocrine System-

Koichi Sato, Takeo Maekawa, Takanori Haba, Kiyotaka Yabuki, Yoshiaki Okahara, Akira Ishiguro, Hidenori Tsumura*, Yozo Watanabe*

Department of Surgery, Juntendo Izu Nagaoka Hospital
*Department of Surgery, Koshigaya City Hospital

The physiological and morphological changes that were present more than twenty years after selective vagotomy with pyloroplasty (SV + P) were studied. Percent reductions in basal and maximal acid output were well maintained similar to the level of early stage after SV + P (78.2 and 75.8% of preoperative values, respectively). Basal and test meal-stimulated gastrin concentrations were also higher than corresponding preoperative levels, and many patients exhibited hypergastrinemia. The histological findings for gastric acid hypersecretors showed that no expansion of intracellular canaliculi was seen and microvilli were well mainteined the same as those before surgery, while in hyposecretors, intracellular canaliculi were expanded and microvilli were disordered and decreased in both number and length. Gastrin producing cell (G-cell) hyperplasia was observed on electron microscopic and immunohistochemical examination. In addition, Ω shaped emiocytotic granule release by G-cells was observed following test meal stimulation. These findings demonstrated that G-cell hyperfunction had been maintained more than twenty years after SV + P.

Key words
selective vagotomy with pyloroplasty, long term follow-up-study, parietal cell, gastrin producing cell, G-cell hyperplasia

Reprint requests
Koichi Sato Department of Surgery, Juntendo lzunagaoka Hospital
1129 Nagaoka, lzunagaoka-cho, Tagatagun, Shizuoka, 410-22 JAPAN

Accepted
September 13, 1995

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