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  • Title: Gastric acid secretion and risk of recurrence of duodenal ulcer within six to eight years after truncal vagotomy and drainage.
    Author: Kronborg O.
    Journal: Gut; 1974 Sep; 15(9):714-9. PubMed ID: 4435586.
    Abstract:
    The value of insulin and augmented histamine tests in predicting recurrence of duodenal ulcer within six to eight years after truncal vagotomy and drainage was assessed in a series of 500 consecutively and electively operated patients. Criteria of recurrence were established by a discriminative analysis of gastric acid secretion parameters. Recurrence was predicted with a probability of about 75% in patients with dyspepsia, the proportion between recurrences and dyspeptic nonrecurrences being 1:1. The discriminatory ability of the insulin test was no better than that of the postoperative histamine test. Men with a preoperative PAO > 46.1 m-equiv/h had a risk of recurrence of 21%, women with a PAO > 41.5 m-equiv/h, 28%. Below these levels the risk was 5 and 1% respectively, demonstrating that recurrence after vagotomy is related to the number of parietal cells before vagotomy. A rationale is provided for antrectomy and vagotomy in duodenal ulcer patients with a high number of parietal cells.
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