Bile acid and lysolecithin concentrations in the stomach of patients with gastric ulcer: before operation and after treatment by highly selective vagotomy, Billroth I partial gastrectomy and truncal vagotomy and pyloroplasty.

Bile acid and lysolecithin concentrations in the stomach were measured in normal subjects and in patients with gastric ulcer (GU) before operation and more than 1 year after highly selective vagotomy, Billroth I partial gastrectomy (PG) and truncal vagotomy and pyloroplasty. Before operation, patients with GU had significantly (P less than 0.001) higher bile acid concentrations in the stomach than normal people. After highly selective vagotomy, bile acid concentrations were significantly lower than in preoperative GU patients and were also significantly lower than in patients after PG, but were still higher than in normal people. Postprandial and peak lysolecithin concentrations after highly selective vagotomy were significantly lower than after partial gastrectomy. The therapeutic effect of highly selective vagotomy in the surgical treatment of GU may be due not only to reduced acid-peptic 'attack' on the gastric mucosa, but also to reduced duodenogastric reflux of 'bile'.