Gastric acid response to sham feeding and pentagastrin before and after parietal cell vagotomy in patients with duodenal ulcer.

The influence of sham feeding (PAOSh) preceding pentagastrin-stimulated gastric acid secretion (PAOPg) was investigated in 28 patients with duodenal ulcer (DU) before vagotomy and in 36 after parietal cell vagotomy (PCV). Sham feeding had little influence on PAOPg, and it is concluded that the two secretion tests may be combined. The ratio PAOSh/PAOPg was significantly reduced by PCV. Fourty-four patients with DU were studied for 1 year after PCV, and their PAOPg was measured preoperatively and their PAOPg and PAOSh postoperatively. Seven of the 44 patients had recurrent ulcer within 1 year. PAOPg had no predictive value pre- and post-operatively, but postoperative PAOSh and PAOSh/PAOPg were both significantly higher in patients with recurrent ulcer. It is concluded that PAOSh and PAOSh/PAOPg after PCV may assess completeness of vagotomy, but the relationship between PAOSh and risk of recurrent ulcer may be stronger than that between PAOSh/PAOPg and recurrence.