Distribution of a liquid meal within the stomach and gastric emptying after vagotomy and drainage operations.

The intragastric distribution of a radionuclide labelled liquid meal was studied in 62 patients with duodenal ulceration by means of a gamma camera imaging system. A total of 85 gastric emptying studies (23 preoperative and 62 postvagotomy tests) revealed three distinct patterns of distribution. The activity distribution in the stomach after vagotomy showed a slower rate of return and a decreased accumulation of the meal in the proximal part of the stomach compared with the pattern in the intact stomach. The return of the liquid meal to the proximal stomach was considered to be a physiological process controlled by vagal reflexes and changed by a vagotomy. These observations made during emptying of a liquid meal seem to give rise to a better differentiation of the motor patterns after various types of gastric operations. With a quantification of the intragastric patterns of distribution it may be possible in a prospective study to give a more graded evaluation of changes induced by vagotomy than is possible with the traditional characterisation of gastric emptying.