Ultrastructure of parietal cells before and after extended parietal cell vagotomy in patients with duodenal ulcer and their complications.

Since 1979 we have treated 149 patients with duodenal ulcer by extended parietal cell vagotomy (EPCV). Electron microscopy of parietal cells from gastric body mucosa and gastric acid secretory test were carried out in 22 randomly selected patients before and after EPCV. It was shown that before EPCV the ultrastructure of parietal cells presented the feature of vigorous section identical to the hyperfunctional secretion of gastric acid. The ultrastructure of parietal cells presented the feature of acute depression of secretory function, which was identical to a significant reduction of secretory function of gastric acid 0.5-6 months after EPCV. Two to 10 years after operation, however, especially over 10 years after EPCV, the ultrastructural changes of parietal cells gradually returned to normal, but gastric acid secretion remained at a low level, without preoperative secretory capacities. The results of this study provide a histological basis for the application of extended parietal cell vagotomy in the treatment of duodenal ulcer and its complications.