The effect of parietal cell vagotomy and selective vagotomy with pyloroplasty on gastric acid secretion. A prospective randomized study.

The insulin- and pentagastrin-stimulated gastric acid secretion was studied before and 1 week, 1 month, 6 months and 1 year after parietal cell vagotomy (PCV) and selective vagotomy with pyloroplasty (SV + P) in 50 patients who took part in a consecutive randomized trial. The randomization and the operations were performed in such a way that the extent of the denervation of the proximal stomach was identical in the two groups. Basal acid output and the insulin-stimulated acid secretion were significantly increased from 1 month to 1 year after PCV, while there was no such increase after SV + P. There was no change of the pentagastrin-stimulated acid secretion (PAOP) from 6 to 12 months in either groups. One year postoperatively PAOP was significantly greater after PCV than after SV + P. The results are compatible with vagal reinnervation after PCV and support the assumption of a sprouting from the innervated gastric antrum.