Changes in gastric secretion with time after vagotomy and the relationship to recurrent duodenal ulcer.

We studied 29 patients who had gastric secretion tests after a vagotomy for duodenal ulcer. There were 14 patients who developed a recurrent duodenal ulcer during the follow-up period and 15 patients who remained free from recurrence. Insulin-stimulated gastric secretion increased with time in the recurrent ulcer group, but not in the group with a satisfactory outcome. On the basis of our results, post-vagotomy patients could be divided into three groups. The first group had a high secretion immediately after the operation and it remained high. The risk of recurrent ulcer in that group was about 50%. The second group had an initially low secretion which increased with time, and the risk of recurrent ulcer in that group was the same as for the first group. The third group had an early low secretion which did not increase with time and the risk of recurrence in this group was less than 5%.